Treatment and Medication Options for Colon and Rectal Cancer
If you have colon cancer or rectal cancer, potential treatment options include surgery, radiation therapy, or medication — or some combination of these.
Surgery
Surgery is 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.
If the cancer has spread to other organs, those tumors may be 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 treatment before surgery to try to shrink the tumor, or after surgery to kill any remaining cancer cells. Radiation therapy is more common for treating rectal cancer than colon cancer, or for treating cancer that has spread to other parts of the 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 the body or come back after earlier treatment. Or they may be used before surgery to try to shrink the tumor, or after surgery to kill any remaining cancer cells.
Chemotherapy uses medicines that work throughout the 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:
- atezolizumab (Tecentriq, Tecentriq Hybreza)
- dostarlimab (Jemperli)
- ipilimumab (Yervoy)
- nivolumab (Opdivo)
- pembrolizumab (Keytruda)
