Chemotherapy uses drugs to destroy colorectal cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Chemotherapy may be used: Before surgery—to shrink the tumor and decrease the amount of tissue that needs to be removedAfter surgery—to kill any remaining cancer cells and decrease the risk of returnIn combination with radiation therapy to shrink tumorTo help relieve symptoms of metastatic cancer and extend survival time
There are a variety of chemotherapy drugs. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for colorectal cancer may include: 5-Fluorouracil (5-FU) with or without leucovorin or oxaliplatinCapecitabine with or without oxaliplatinOxaliplatinIrinotecanTrifluridine and tipiracil
Chemotherapy for colorectal cancer is usually given through an IV, but some forms can be given by mouth. It is delivered in cycles over a set period of time. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.
Though the drugs are targeted to cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include: Increased frequency and urgency of bowel and bladder functionNumbness, pain, or burning sensation in the the hands and feet—peripheral neuropathyNausea and vomitingDiarrheaFatigue due to anemiaConfusion, forgetfulness
A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.
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Colorectal cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf. Accessed December 4, 2015.
Colorectal cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 12, 2015. Accessed December 4, 2015.
Colorectal cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/colorectal-cancer. Updated July 2014. Accessed December 4, 2015.
Rectal cancer treatment option overview. National Cancer Institute website. Available at: http://www.cancer.gov/types/colorectal/patient/rectal-treatment-pdq#section/_135. Updated June 30, 2015. Accessed December 4, 2015.
Last reviewed June 2016 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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