Chemotherapy is a type of cancer treatment that uses powerful drugs to kill cancerous cells. It is a systemic treatment, meaning that the drugs affect cancerous cells throughout the body to prevent them from spreading.

There are many different types of chemotherapy drugs used to treat specific types of cancer. Chemo can be prescribed at different stages of treatment, and it can be administered in a variety of ways.

Chemotherapy drugs stop the growth of cancer cells by either killing the cells or by stopping them from dividing. It may be given alone or with other treatments, such as surgery, radiation therapy, or targeted therapy.

Chemotherapy is given at different points along your cancer journey, depending on your stage and cancer type. Colon cancer patients typically undergo chemotherapy after surgery; rectal cancer patients often receive chemotherapy before and during radiation, and after surgery.

Chemotherapy can be defined by when it is given – common terms to be familiar with are given below:

Your medical team will review your medical records and perform tests to plan your cancer treatment. If and when you go on chemo will depend on:

• Size and location of the cancer
• Your age
• Your overall health (What can you tolerate?)
• Other medications you are taking, including vitamins and supplements
• Other factors, such as comorbid diseases you have or other diagnosed conditions

Doctors determine chemotherapy plans for patients based on treatment guidelines, like the NCCN Guidelines.

If you agree to the treatment plan, you may be advised to get a port-a-cath or central line. A “port” is a small device surgically placed in your chest, above your heart, that allows for easy access to your bloodstream. A central line or a PICC (peripherally inserted central catheter) line is usually placed in your arm and connected to one of your veins. If you’re receiving IV chemotherapy, these make administering the drugs much easier and avoids repeated sticks to start an IV.

You will schedule an appointment for chemo, which typically takes place in an infusion clinic (if you’re receiving IV chemotherapy). Your labs will be drawn to ensure you’re well enough to receive chemo. If your blood counts look OK, you’ll head to the infusion clinic where an oncology nurse will access your port or central line and hook up bags of fluid and drugs. Sometimes you will be given drugs, like anti-nausea, before the treatment begins to help with side effects. Plan for a long day.

Chemotherapy treatment is typically administered in cycles. Each cycle lasts 2-3 weeks, giving you time to recover. Each oncologist has their own approach to cycles, however most colon cancer patients receive 6-12 cycles of treatment; rectal cancer patients may face 2-4 cycles of chemotherapy before radiation, receive chemoradiation while undergoing radiation treatments, and then conclude with 2-4 more cycles of treatment.

Your treatment cycle, schedule, and dosage will depend on the exact drug you’re receiving.

Chemotherapy treatment comes with side effects. Most chemotherapy treatments kill both good and bad cells, which can unfortunately lead to undesired side effects and make you feel weak and tired. Everyone’s body handles chemotherapy differently, no two patients experience it exactly alike.

However, some side effects tend to show up more commonly than others, for example many patients receiving oxaliplatin experience neuropathy.

We’ve compiled information and tips for handling side effects.

Depending on your exact chemotherapy treatment, the team may advise you on food and drink that you should or should not consume on the days that you receive treatment.

Also, ingesting certain substances, like supplements, can negatively interact with chemotherapy, so be sure to follow your medical team’s directions and tell your doctor about anything and everything you’re taking, even vitamins and other over the counter supplements.

Your doctor may recommend one or more chemo drugs during treatment. If you receive more than one drug at a time, that’s called “combination therapy.”

Sometimes chemo drugs are combined with one another; sometimes they’re combined with targeted therapy drugs.

Some common treatment combinations using these drugs include:

Any of the above may be administered with one of the following targeted therapies: cetuximab (Erbitux®), bevacizumab (Avastin®), or panitumumab (Vectibix®).

In addition, FOLFIRI may be combined with either of these targeted therapies: ziv-aflibercept (Zaltrap®) or ramucirumab (Cyramza®).

Your doctor will likely start planning your treatment based on the standard of care. The term “standard of care” means the treatment you are receiving is accepted by medical experts as a proper and effective treatment for colon or rectal cancer. You might hear them refer to it as best practice, standard medical care, and standard therapy.

We work hand in hand with the National Comprehensive Care Network (NCCN) Clinical Practice Guidelines in Oncology (NCCN Guidelines®) to make sure patients have accurate information.

Both doctors and patients can access the guidelines, and NCCN also offers Guidelines for Patients in multiple languages.

You get the ultimate say in what you will/won’t receive. Be sure to research all your options and follow a treatment plan that fits with your preferences and values.

If you want to learn more about chemotherapy, the websites below offer reputable information.

A service of the U.S. National Library of Medicine and the National Institutes of Health, this database includes information on the precautions, side effects, and proper use of thousands of prescription drugs, over-the-counter medications, herbs, and supplements.

The NCI has compiled consumer-friendly overviews for more than 250 common cancer drugs and drug combinations. Each summary includes information on appropriate drug usage, side effects, drug interactions, and links to current clinical trials in which the drug is being used.

The ACS outlines chemotherapy, targeted therapy, and immunotherapy options for colorectal cancer, as well as providing information as to when each may or may not be used.