Colorectal Cancer Treatment

Approximately 85% of patients with CRC can have a curative operation to remove the involved colon and mesentery. Patients need a preoperative colonoscopy and CT of the abdomen to rule out liver metastases. Any colonic or rectal polyps are removed. Resections that save the sphincter in patients with rectal cancer assist in reducing the number of abdominoperineal excisions necessary. 5-Fluorouracil (5-FU) is a cytostatic drug that inhibits DNA synthesis in cancer cells.

The postoperative use of 5-FU along with levamisole, an immunomodulator drug, improves postoperative cure rates. Levamisole is believed to antagonize the effect of 5-FU on RNA synthesis, potentially reducing the toxicity associated with 5-FU administration. Similarly, improved cure rates are noted when leucovorin, a folic acid derivative, is used along with 5-FU.

Because the prognosis is poor for advanced-stage CRC, these patients should be enrolled in clinical trials to possibly improve their prognosis and associated survival.

If tests show that you have cancer, you should talk with your doctor and make treatment decisions as soon as possible. Studies show that early treatment leads to better outcomes.

How treatment is planned

There are a number of factors that help your specialist plan your treatment

• The type and size of the cancer
  
• Your general health
  
• Your age
  
• Whether the cancer has spread (the stage)
  
• What the cancer cells look like under the microscope (the grade)

You may find other people you meet are having different treatment from you. This may be because some of the factors above are different. Or it may be because their doctor has different views to yours. Don't be afraid to ask your doctor or nurse any questions you have about your treatment.

Treatment for colon cancer may include surgery, radiation therapy or chemotherapy, or a combination of these approaches.

Surgery - Surgery is the most common treatment for all stages of colon cancer. Depending on the stage and size of your tumor, your doctor will remove your cancer with one of the following methods:

In many cases of bowel cancer the surgeon can cut away all of the cancer. Some people who have this treatment will be cured. This means that their cancer never comes back.

Whether your surgeon can try to cure your cancer by cutting it all away depends on

* The size of the cancer
* Whether the cancer has spread (the stage)
* Your general health

Unfortunately, not everyone who has surgery will be cured. Although it may seem possible to cure your cancer, your surgeon will not know the exact stage of your cancer until after you have had your surgery. If the cancer has spread to your lymph nodes, it is possible that some cells have travelled on to other parts of the body, where they may begin to grow into secondary cancers. To try to prevent this, you may be offered further treatment after your surgery.