• Cancer
• Colorectal Cancer

Know Your Options for Colorectal Cancer Treatment

When you receive a diagnosis of colorectal cancer, you may feel unsure about which of the many treatment options is best for your specific condition. Your doctor will work with you to create a plan to manage and treat your cancer, says James Ouellette, DO, FACS, Premier Surgical Oncology.

First, your doctor will perform tests to determine the stage of your cancer. Blood work and a computed tomography scan (CT scan) provide information that doctors use to determine if the cancer has metastasized — or spread — to other parts of the body.

“Once we know the stage, then we can begin forming a treatment plan,” Dr. Ouellette says.

A patient’s treatment depends on whether the cancer is colon cancer or rectal cancer.

“Many times they are treated differently,” Dr. Ouellette says.

Treatment Goals

In many cases, colorectal cancer can be cured with treatments. When a cure is not possible, treatment goals include shrinking the cancer or keeping it under control for as long as possible. Colorectal cancer treatments can reduce symptoms and improve your quality of life.

The most common treatments include: 

• Surgery, including minimally invasive options 
• Chemotherapy
• Radiation

In more advanced cases or those that do not respond to chemotherapy or radiation, additional therapies can help, says the American Cancer Society.

Targeted therapy refers to medicines that target specific cells involved in blood vessel formation, to stop the cancer from growing or spreading.

Ablation or embolization are used to treat a cancer that has spread. Ablation is a way to kill a tumor without surgically removing it. Embolization stops blood flow to a tumor.

Treating Colon Cancer

If you have colon cancer, two types of treatment may be involved, Dr. Ouellette says.

“If there is any chance of a cure, surgery is one of the treatments,” Dr. Ouellette says.

When surgery is used, a section of the colon that contains the tumor is removed. Your doctor will also remove and check lymph nodes during surgery, to determine if the cancer has spread.

Checking the lymph nodes is also the final step in determining the stage of cancer.

Sometimes, surgery alone is enough, says Dr. Ouellette. If lymph nodes are involved, chemotherapy may be needed or considered after surgery.

Treating Rectal Cancer

If you have rectal cancer, additional staging tests are needed. Dr. Ouellette says patients can expect to undergo an endoscopic ultrasound or magnetic resonance imaging (MRI) tests to determine how deep the tumor is and whether lymph nodes are involved.

These tests help your doctor decide if any treatment is needed before surgery. Such care, called neoadjuvent therapy, may involve chemotherapy or radiation. This treatment aims to shrink the tumor to improve the doctor’s ability to perform surgery.

The goal of rectal cancer treatments, says Dr. Ouellette, is to avoid the need for a colostomy if possible.

Making Decisions About Your Care

Once you complete all necessary staging tests, you should discuss the pros and cons of available treatments with your doctor, says Dr. Ouellette.

“Treatments have significantly improved in the last 10 to 15 years,” Dr. Ouellette says.

Be sure to ask your doctor any questions about colorectal cancer treatments that you may have.

Doctors at the Premier Health Cancer Institute follow a special algorithm for treating colorectal cancer. This means that a specific treatment path is followed to help ensure the best outcomes. Multiple specialists work together to create the algorithm. The process also allows your cancer care team to better communicate with your primary care doctor about the general care you will receive. Of course, each patient’s care plan is individualized to meet his or her specific needs, says Dr. Ouellette.

As you decide which treatment plan to follow, you may want to seek a second opinion. The American Cancer Society says recommendations from another doctor can provide additional information and help you feel more secure about the path you choose.

You may also want to consider taking part in a clinical trial. These are research studies that test new treatments and procedures. Clinical trials are one way patients can get access to newer treatments.

Clinical trials are not for everyone. If you are interested in participating in one, talk with your doctor about how you can take part.

Complementary treatment methods, such as vitamins, herbs, acupuncture or massage, can be used alongside your medical treatment to ease symptoms and make you feel better. But be sure to talk with your doctor about using these to ensure they’re safe for you.

If treatments are no longer working, or if the cancer is advanced, you may decide to stop treatments or to forego treatment. If you choose no treatment, you still can receive care to maintain your quality of life as well as to help with pain and other symptoms. Your doctor can assist you with this kind of supportive care.

“Treatments have significantly improved in the last 10 to 15 years,” Dr. Ouellette says. “It is important for people to realize that even if they do have metastatic disease when they are diagnosed or if it develops later, there may still be effective treatments for them.”

Source: James Ouellette, DO, FACS, Premier Surgical Oncology; American Cancer Society

James R. Ouellette, DO

Premier Surgical Oncology

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