Colorectal Cancer

Colorectal cancer is a malignancy arising in the large bowel (colon) or the rectum (at the end of the colon). Broadly speaking patients may receive oncology treatment for colorectal cancer after an operation has been performed, when treatment may be given to reduce the chance of the cancer recurring. If colorectal cancer has spread, treatment may alleviate some of the symptoms of the disease and improve quality of life.

Treatments for bowel cancer have improved considerably in the last few years, with the introduction of several new drugs which have meant improved success in both these scenarios.

 

Bowel cancer patients’ cases are reviewed in the appropriate Multi-Disciplinary Meetings, either in-house or externally depending upon the particular circumstances – at these meetings, all cases undergo review, with decisions made regarding any requirements for additional chemo or radiotherapy following discussion.

Chemotherapy If the surgeon completely removes a bowel cancer we know there may sometimes still be a risk the cancer could show itself again. Some patients are more at risk of recurrence than others and depending on the features found at the microscopic level by the pathologist (who examines the tissue removed by the surgeon) your oncologist may recommend you receive treatment after your operation to reduce the risk of recurrence – this is sometimes called adjuvant treatment.

Most commonly this treatment is with drugs (chemotherapy) and given for up to 6 months. It may involve the use of one or several chemotherapy drugs depending on your individual circumstances, but these options, and the side-effects which accompany each type of treatment will be discussed fully. Sometimes the decisions around this type of treatment are not clear-cut and before coming to any recommendation, your oncologist will take into account your own views on treatment.

Commonly treatment is given fortnightly or every 3 weeks, on a day-case basis in the Oncology Unit and often patients do not need to stay overnight. Before the chemotherapy is given you will have a blood test and your specialist oncology nurse will assess the extent of any side – effects you have experienced. If necessary, modifications may be made to your treatment program. Drugs commonly used in this situation include 5-fluorouracil, oxaliplatin and Capecitabine.

Radiotherapy Occasionally radiation therapy is used as part of the treatment for colorectal cancer. This is most often given with chemotherapy prior to surgery but sometimes it is used after an operation. Radiation therapy (radiotherapy) is treatment with high-energy X-rays – this is usually delivered at Beatson West of Scotland Cancer Centre. Treatment is usually given on an out-patient basis over 4 or 5 weeks – each session takes only a few minutes but you may be at the hospital for 30-45 minutes each day.

Advanced disease If your cancer is more advanced, treatment may focus more on the use of chemotherapy alone. Whilst this may include the chemotherapy agents described above, it may also include other drugs called biologicals (Avastin / Erbitux). Your oncologist will discuss which particular combination of treatments is most appropriate in your case but commonly used drugs include 5-fluorouracil, Oxaliplatin, Capecitabine and Irinotecan. Commonly patients undergo CT scanning to determine the extent of their disease, with such scans repeated after several cycles of treatment to determine if the chemotherapy is helping.

 

 

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