Treatments

A diagnosis of bowel cancer will mean you have to make a number of different decisions about treatment. Your treatment options will vary depending on the size and location of the tumour, as well as your overall health.

Remember, everyone is different and your doctor will focus on the best treatment options to suit you.

There are a number of treatments available for bowel cancer, including:

Try to gather as much information as possible about your treatment options and don’t be afraid to ask questions. You need good information to make the best decisions for your health.

Treatment for bowel cancer usually involves surgery to remove the tumour, but some people may also require radiation therapy, chemotherapy and/or targeted therapies.

Surgery

The type of surgery you have for bowel cancer will depend on where the cancer is in the bowel, the size and type of the tumour and whether the cancer has spread. There are several different kinds of surgery depending on how much of the bowel, and which part, is removed. Surgery for bowel cancer may be done as open surgery or as keyhole surgery. Again, it will depend on the nature and size of the cancer. Some of the more common types of surgery are:

  • Local resection in which the surgeon removes the cancer from the lining of the bowel during a colonoscopy. This is only done with very early-stage cancers.
  • Total Colectomy involves removal of the whole colon.
  • Hemi-colectomy involves the removal of half the colon, either the right or the left side depending on where the cancer is located.
  • Sigmoid colectomy involves the removal of a part of the bowel known as the sigmoid colon.
Sometimes during surgery to remove bowel cancer, the bowel cannot be rejoined and in these cases the surgeon will open the bowel onto the skin of the abdominal wall (this opening is called a stoma). A bag is then worn on the abdomen to collect bowel motions. This is known as a colostomy bag. This is usually a temporary situation, but for some people it may be permanent. The length of time it takes you to recover from surgery will vary. You are likely to be in hospital for a few days and to be sore for some time. Surgery for bowel cancer is a major operation so you’ll need to take things easy for a while, but you will be encouraged to keep active.

Radiation Therapy

Radiation therapy is sometimes used in people with bowel cancer. It is more commonly used in those with rectal cancer before surgery to try and shrink the size of the tumour. It is less commonly used after surgery for bowel cancer, but the aim is to try and shrink any remaining cancer cells. Radiation therapy uses high energy x-ray beams to kill the cancer cells and is delivered by a special machine which directs the x-ray beams to the tumour site. Treatment is generally given every day for a period of weeks.

As with any treatment, you may experience side-effects during radiation therapy. Side-effects may affect you no matter which area of the body you’re having radiotherapy to. Some side-effects are more common than others. These can include:
  • Skin irritation
  • Tiredness (fatigue)
  • Feeling sick (nausea or vomiting)
  • Problems with eating and drinking
  • Flu-like symptoms
  • Hair loss
If you experience any side effects during radiation treatment, tell your medical team. They are in the best position to help you manage any side-effects.

Chemotherapy

Surgery for bowel cancer is often followed by chemotherapy. Chemotherapy medicines work to destroy the cancer cells or control their growth. When you have chemotherapy, you are usually given a combination of two or more medicines intravenously (through the vein). Chemotherapy is most commonly given every three to four weeks over a period of several months. Chemotherapy kills rapidly growing cells like cancer cells, but can also kill other healthy cells that grow quickly, such as those in the bone marrow, digestive tract and hair follicles. Chemotherapy treatment can lead to a number of side-effects, including:
  • Feeling sick (nausea and vomiting)
  • Hair loss
  • Tiredness (fatigue)
  • Increased risk of infection.
If you’re experiencing side-effects as a result of chemotherapy, speak to your medical team about the best way to manage these. There are medicines that can be used to effectively control or minimise side-effects.