Treatment and Medication Options for Colon and Rectal Cancer
If you have colon cancer or rectal cancer, you will likely have surgery, radiation therapy, or medication — or some combination of these treatments.
Surgery
Surgery is often the first choice for many early-stage colon cancers and most rectal cancers. Doctors can remove diseased tissue during a colonoscopy. Or you may need to have an entire section of your colon or rectum removed.
In that case, either the remaining sections are reattached to each other or you may need a procedure called a colostomy, which creates an opening in your abdomen for stool to pass through and be collected in a bag. This situation is usually temporary.
With cancer that has spread to other organs, you may have those tumors removed during the colon surgery, or at a later time.
Radiation
Radiation therapy employs various types of radiation to destroy cancer cells. You may get this before surgery to try to shrink the tumor, or after surgery to kill any remaining cancer cells. It’s more common in treating rectal cancer than colon cancer, and in treating cancer that has spread to other parts of your body.
Medication Options
Several different kinds of drug treatments can be used for colon and rectal cancer. These are most often used for cancer that has spread throughout your body or come back after earlier treatment. Or you may get them before surgery to try to shrink the tumor, or after surgery to kill any remaining cancer cells.
Chemotherapy uses medicines that go throughout your body to kill cancer cells. Commonly used drugs include:
- capecitabine (Xeloda)
- fluorouracil (Adrucil)
- irinotecan (Camptosar)
- oxaliplatin (Eloxatin)
- trifluridine and tipiracil (Lonsurf)
Targeted therapy involves drugs that attack cancer cells with unique genetic or protein targets. Tumor cells may be tested to see if one might be helpful for you. Targeted therapy drugs approved for treating stage 4 colorectal cancer include:
- adagrasib (Krazati)
- bevacizumab (Avastin)
- cetuximab (Erbitux)
- encorafenib (Braftovi)
- fruquintinib (Fruzaqla)
- panitumumab (Vectibix)
- ramucirumab (Cyramza)
- regorafenib (Stivarga)
- tucatinib (Tukysa)
- ziv-aflibercept (Zaltrap)
Other therapies approved by the U.S. Food and Drug Administration include encorafenib (Braftovi) in combination with fluorouracil-based chemotherapy and cetuximab (Erbitux).
Immunotherapy uses the body’s own immune system to battle cancer. Certain drugs called checkpoint inhibitors have been shown to help a small subset of patients with colorectal cancer whose tumors have specific genetic changes. The approved drugs are:
- ipilimumab (Yervoy)
- nivolumab (Opdivo)
- pembrolizumab (Keytruda)
