Colorectal Cancer Treatment and Care

A shared decision-making approach to your colorectal cancer treatment and care will ensure that you play a key role in the process.

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Learn more below on how a treatment plan is chosen and the types of treatment by stage. 

Treatment Terms to Know

  • Primary treatment: main treatment for cancer 
  • Neoadjuvant treatment: given before surgery 
  • Adjuvant treatment: follows primary treatment 
  • First-line treatment: first treatment given to patients with metastatic CRC 
  • Second-line treatment: given if the first-line treatment fails

How a Treatment Plan is Chosen

Choosing a treatment plan can be hard. A lot of it will depend on the location, type, and stage of your cancer, and even the types of biomarkers expressed in your tumor. Understanding your treatment options is essential so that you can participate in shared decision making, where you make healthcare decisions together with your doctors. This ensures the decisions that are made align with your goals as a patient. 

You may be offered the standard of care or a clinical trial. Before making treatment plans, it’s a good idea to get a second opinion. If the second opinion is the same as the first, great. If it’s different, you may want to check with a third expert to help you make your decision. Ideally, you can have a treatment team comprised of many doctors working together to discuss all of your treatment options and possible treatment combinations. You can learn more about the types of doctors that may make up your treatment team in Your Guide in the Fight

More About Biomarkers and Cancer Treatment

A biomarker is a biological molecule found in blood, other body fluids, or tissues. They also appear in tumors. Biomarkers play a key role in developing individualized treatment plans, or “personalized medicine.” Make sure your doctor tests for biomarkers at diagnosis so you can know your tumor type. Some common biomarkers in colorectal cancer include: 

  • KRAS & NRAS
  • BRAF
  • PIK3CA
  • Carcinoembryonic Antigen (CEA)
  • Microsatellite Instability High (MSI-H)
  • Tumor Sidedness (Right vs. Left)

Read more on biomarkers and the guidelines for biomarker tests.

Liquid Biopsies and ctDNA

By now, it’s likely that you’ve heard the terms ctDNA, cfDNA, Next Generation Sequencing (NGS) and liquid biopsies thrown around, and with many acronyms and various test types out there for colorectal cancer, it can become confusing to understand how they can impact treatment and care. We're here to help.

Colorectal Cancer Treatment Options

There are a variety of options for rectal and colon cancer treatment. It’s important to discuss all of your options with your doctor before you begin treatment. Here are seven of the most common treatment options.

Surgery

With colon cancer, your first treatment may be surgery to remove the primary tumor. Rectal cancer surgeries often follow radiation and chemotherapy.

Chemotherapy

Chemotherapy is used to stop or limit the growth of rapidly dividing cancer cells. It can be taken by mouth (oral chemotherapy), injected into a vein (intravenous chemotherapy), or placed directly into the abdomen (regional chemotherapy).

Immunotherapy

Immunotherapy is a type of treatment that uses certain parts of a person’s immune system to fight diseases such as cancer. The goal of immunotherapy is to boost a patient’s immune reaction to the cancer cells, allowing them to fight the disease more effectively.

Targeted Therapies

Targeted therapies are drugs that block the growth of cancer by interfering with the molecules involved in tumor growth and spread. As a treatment for colorectal cancer, they have been shown to be helpful in patients with stage IV cancer, but not in patients with stage III.

Radiation Therapy

Radiation therapy is not often used to treat colon cancer unless it is in the treatment of tumors that have grown next to or into other organs. Radiation therapy may sometimes be used to relieve symptoms and improve your quality of life.

Complementary Alternative Medicine (CAM) and Integrative Care

If you are considering complementary or alternative approaches to help you feel better, talk to your doctor. No alternative method has been proven safe or effective by conclusive scientific evidence to treat colon or rectal cancer.

Colorectal Cancer Clinical Trials

Clinical trials for colorectal cancer test new treatment options include drug therapy, surgery, radiation, and combination procedures. There are also clinical trials that test new ways to stop cancer from recurring or reduce treatment side effects.

More About Colorectal Cancer Treatment

Side Effects from Treatment

Talk with your health care team about possible side effects before beginning treatment and during treatment. Not everyone experiences the same side effects, nor are side effects experienced in the same way. You may also want to address specific concerns with your doctor, including any questions about fertility after cancer treatment.

Fertility After Colorectal Cancer Treatment

If you are an adult of childbearing age, you may be wondering if colorectal cancer treatment can affect your fertility. The answer is: it depends. Infertility after treatment can affect both men and women. And with such a wide range of treatment options, you should speak with your doctor to understand the possible fertility complications of your treatment plan. But getting the cancer treatment you need shouldn’t stop you and your family from having children – you have options.

Your Guide in the Fight

We know a colorectal cancer diagnosis is overwhelming. We’re here to walk you through it from the day of diagnosis through survivorship. Your Guide in the Fight is a three-part book designed to empower and point you toward trusted, credible resources.