Treatment Options for Colorectal Cancer

What kind of surgical colon cancer treatment options do I have?

Small polyps are usually removed during the colonoscopy without a need for any incision on your body. At Stanford, larger or complex polyps are generally removed with minimally invasive surgery that removes the segment of colon where a polyp or polyps have been found. That more comprehensive approach can eliminate the need for a subsequent operation if cancer is ultimately found in the polyp. The same operation is performed if a cancer is found on colonoscopy. Learn more about colonoscopies.

Often, if the cancer has not spread, surgery to remove the cancerous portion of colon is curative and no further treatment is needed. For locally advanced tumors or tumors that have spread to other organs, Stanford specializes in multidisciplinary surgical treatment for colon cancer that may involve urologists, liver surgeons, gynecologic oncologists and reconstructive plastic surgeons as necessary. They are expert in surgical removal and reconstruction strategies to give patients as comfortable a lifestyle as possible.

Is radiation an option to treat colon cancer?

Except in rare circumstances, radiation is not used in the treatment of colon cancer but it is of great value in the treatment of rectal cancers. Although colon and rectal cancers are similar in appearance, they are in very different locations. The pelvic bones, vagina or prostate, bladder, blood vessels and nerves that surround the rectum make surgery for rectal cancer more challenging.

Is chemotherapy used to treat colon cancer?

Chemotherapy is typically not used for the earliest stages of colon cancer. In some high-risk early cancers (stage II), chemotherapy may be used after discussion with the medical oncologists. It is routinely used for Stage III and Stage IV cancers. Advanced disease can now be managed for many years with chemotherapy that still allows a full and productive life.

How is a particular chemotherapy treatment selected?

When selecting chemotherapy, doctors consider the stage of disease, a patient’s general state of health and other health problems. Choice of different chemotherapy regimens is based on evidence-based guidelines that are determined by results of clinical trials.

At Stanford, doctors will use a tissue sample from the tumor of metastatic colon cancers to analyze its genome—the particular set of biochemical directions that order a tumor’s growth. Some tumors will have a genetic profile with particular molecular pathways that can be targeted with chemotherapy.

Doctors are continuously learning new ways to combine chemotherapies with and without targeted therapies and new chemotherapies are emerging. Learn more about chemotherapy.

How is treatment chosen?

Specific treatment for colorectal cancer will be determined by your doctor based on:

• Your age, overall health, and medical history
• Extent of the disease
• Your tolerance for specific medications, procedures, or therapies
• Your opinion or preference
• Molecular features of your tumor

After the colorectal cancer is diagnosed and staged, your doctor will recommend a treatment plan. Learn about Stanford's GI Tumor Board.

Learn more about specific treatments

Your plan may involve one or more of the following treatments:

Studies have shown that chemotherapy after surgery can increase the survival rate for patients with some stages of colon cancer. Chemotherapy can also help slow the growth or relieve symptoms of advanced cancer.

Surgery

Often, the primary treatment for colorectal cancer is an operation called a colon resection, in which the cancer and a length of normal tissue on either side of the cancer are removed, as well as the nearby lymph nodes.

Newer medications called targeted therapies may be used along with chemotherapy or sometimes by themselves. For example, some newer medications target proteins that are found more often on cancer cells than on normal cells. These medications have different (and often milder) side effects than standard chemotherapy medications and help people live longer. These include Avastin® (bevacizumab), Nexavar® (sorafenib), Torisel® (temsirolimus), Afinitor® (everolimus), Sutent® (sunitinib), and Inlyta® (axitinib). A vaccine for treatment also is under study.

Meet our team of colorectal experts at the GI Cancer Program.