Treatment for colon and rectal cancer
Treatment options for rectal and colon cancer include surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy. These may be as part of a clinical trial.
About treatment for colon and rectal cancer
In the video below, oncologist Rebecca and Cancer Nurse Specialist Claire explain how bowel cancer may be treated.
The term bowel cancer is normally used to talk about colon cancer and rectal cancer. Cancer that starts in the colon or rectum is also sometimes called colorectal cancer.
We have separate information about:
Treatments used for colon and rectal cancer include:
- surgery
- chemotherapy
- targeted therapy
- immunotherapy
- radiotherapy.
You may have a combination of treatments. The results of your tests help your cancer doctor plan your treatment.
The treatment you have depends on:
- the stage of the cancer
- the position of the cancer in the colon or rectum
- your general health
- your preferences.
It is important to talk about treatment options with your doctor. They can explain why they are suggesting a certain treatment plan and how the treatment may affect you.
We understand that having treatment can be a difficult time for people. We are here to support you. If you want to talk, you can:
- call the Macmillan Support Line for free on 0808 808 00 00
- chat to our specialists online
- visit our bowel (colon and rectal) cancer forum to talk to people who have been affected by bowel cancer, share your experience, and ask an expert your questions.
Surgery
Surgery to remove the cancer is one of the main treatments for colon and rectal cancer. If you have colon cancer, the operation usually involves removing the part of the colon where the cancer is. If you have rectal cancer, the operation usually involves removing part or all of the rectum.
For both colon and rectal cancer, the surgeon will also remove nearby lymph nodes. If the cancer has grown into tissue or organs nearby, the surgeon may remove parts of these too.
To treat advanced cancer and relieve symptoms
Sometimes surgery is used to treat colon and rectal cancer that has spread to other parts of the body. This is called secondary or advanced cancer. It may be used to help with symptoms. For example, you may have surgery if the cancer is causing a blockage in the bowel.
Some people have surgery to remove a cancer that has spread to another part of the body, such as the liver or lungs.
Chemotherapy
For colon cancer you may have chemotherapy before surgery. This is called neoadjuvant chemotherapy.
For rectal cancer, some people have chemotherapy as well as chemoradiation before surgery. Chemotherapy may be given before or after chemoradiation.
Having chemotherapy and chemoradiation before surgery is called total neoadjuvant therapy. Some people who have this treatment may not need to have surgery. They will be regularly monitored and will have surgery if the cancer starts to grow again.
For colon and rectal cancer you may have chemotherapy after surgery, to reduce the risk of the cancer coming back. This is called adjuvant chemotherapy.
To treat advanced cancer and relieve symptoms
Colon and rectal cancer sometimes spread to other parts of the body such as the liver or lungs. This is called secondary or advanced cancer. If the cancer has spread, you may have chemotherapy to shrink the cancer and control it for as long as possible.
Some people with advanced cancer have chemotherapy to shrink the cancer before having an operation to remove it.
You may have chemotherapy to relieve symptoms if the cancer has come back after treatment.
Related pages
Radiotherapy
If you have rectal cancer you may have radiotherapy or chemoradiation before rectal surgery. Chemoradiation is when you have chemotherapy and radiotherapy together.
Radiotherapy or chemoradiation before surgery can shrink the cancer. This may mean it can be completely removed with surgery. These treatments also help reduce the risk of the cancer coming back in the rectum, or in the tissues close to it.
Radiotherapy is also sometimes used to relieve symptoms, such as pain or bleeding. This is called palliative radiotherapy.
Targeted therapy
Immunotherapy
Some immunotherapy drugs can be used to treat advanced bowel cancer.
Your cancer doctor can tell you if targeted therapy or immunotherapy may be suitable for you.
Clinical trials
Your cancer doctor may invite you to take part in a clinical trial.
If you are thinking about taking part in a clinical trial it is important to understand what is involved and what it might mean for you. Find out more about taking part in clinical trials.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our bowel cancer information. If you would like more information about the sources we use, please contact us at
informationproductionteam@macmillan.org.uk
National Institute for Health and Care Excellent (NICE). Colorectal cancer. NICE guideline [NG151]. Updated December 2021. Available from: www.nice.org.uk/guidance/NG151 [accessed Jan 2023].
Cervantes A, Adam R, Rosello S, et al. Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology. 2023;34(1):10-32. Available from: www.annalsofoncology.org [accessed Jan 2023].
Date reviewed
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This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.
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