Colon and Rectal Cancer Treatment

Delivering expert treatment based on your individual needs.

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Provider discussing colon cancer treatment options with patient

There are many treatment choices for colorectal cancer. Which may work best for you will depend on a number of factors. These include the cancer type, the tumor size and where it is, and the stage of the cancer. Factors also include your age, overall health, and what side effects you’ll find acceptable.

You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or you may be offered more than one, and asked to decide which one you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision.

Understanding the goals of treatment for colorectal cancer

For many colorectal cancers, the goal of treatment is to cure the cancer. If cure isn't possible, treatment may be used to shrink the cancer or keep it under control for as long as possible. Treatment can also improve your quality of life by helping control the symptoms of the disease. The goals of colorectal cancer treatment can include:

  • Remove the cancer in the colon or rectum
  • Remove or destroy tumors in other parts of the body
  • Kill or stop the growth or spread of colorectal cancer cells
  • Prevent or delay the cancer's return
  • Ease symptoms caused by the cancer, like pain or eating problems caused by pressure on organs

Colon and rectal cancer treatment options

There are several types of treatment for colon and rectal cancer, and many people undergo a combination of treatments. The colon makes up most of the large intestine; the rectum is the bottom six to eight inches of the large intestine. Because colon and rectal cancer are similar, the term “colorectal” cancer is often used. 

Treatments for colon and rectal cancers are divided into two categories. The first is a “local treatment” at the site of  the tumor without affecting the rest of your body. The second is a “systemic treatment” because it uses drugs that travel throughout your body to reach cancer cells.

Local treatment

  • Surgery is the most common treatment for all stages of colon and rectal cancers. 

For colon, options include:

  • Resection of the colon with anastomosis: The surgeon does a colectomy removing  the cancer and some surrounding tissue, then the healthy parts of the intestine are sewn together, called an anastomosis. In a small number of cases the surgery is more complex or the person is very ill, so there may be temporary colostomy put in place.

For rectal, options include:

  • Local transanal excision: For small, early stage disease, the cancer and surrounding tissue are removed with instruments inserted into the rectum through the anus.
  • Resection and anastomosis with or without a temporary ostomy: The surgeon does a “proctectomy,” removing the cancer and surrounding tissue; then the healthy parts of the intestine are sewn together, called an anastomosis. This surgery may involve creating a temporary ostomy; part of the intestine is connected to an opening in the skin or “stoma” for stool to pass through into a bag. This is needed more often in rectal cancer surgery than in colon surgery.
  • Resection and a permanent ostomy: In certain cases, the cancer and surrounding tissue are removed, and a permanent ostomy is required.
  • Radiation therapy uses high-energy X-rays or other radiation to kill cancer cells or keep them from growing. For rectal cancer, radiation is often done first, aiming to shrink the tumor before surgery. Learn more about radiation therapy.

Systemic treatments include:

  • Chemotherapy uses drugs used to slow or kill cancer cells throughout the body. For colon cancer, chemotherapy is recommended if cancer is also found in nearby lymph nodes. For advanced rectal cancers, chemotherapy is often given at the same time as radiation therapy. Learn more about chemotherapy.

Talk to your doctor to learn if you are eligible for a clinical trial (research study). Researchers are discovering new therapies for treating cancer all the time, giving doctors new resources for your care. 

Colon cancer experts

Legacy Cancer Institute, located in Portland, OR, ranks among the nation’s best cancer programs. Our team features some of the region’s most recognized specialists who work together to diagnose and develop a personalized treatment plan for you. Find the right provider and treatment close to home.

Legacy Cancer Institute is accredited as an integrated network cancer program by the American College of surgeons Commission on Cancer (CoC). Learn more about our quality cancer care.

Working together for you

Our cancer experts work together with a common goal: delivering the right care for you.

A range of specialists collaborate regularly in meetings called tumor boards to discuss the best plan for your care. Your treatment plan is made just for you, depending on your general health, your age, your particular cancer and its growth.

Legacy Health collaborates with the OHSU Knight Cancer Institute to advance cancer care in our region. By working together, you benefit from the strength of both leaders in cancer care. As an integrated community cancer program for adults, we make sure that you have access to the latest treatments, technology and research available. 

What happens next

Many cancer treatments can cause challenging side effects. Your cancer team is dedicated to helping you manage these symptoms in the best ways possible. Comfort care can treat symptoms to help improve your quality of life; this is also called palliative care.

To see how well your treatment is working, some of the tests used to diagnose and stage your cancer may be repeated. Your doctor uses these tests to decide whether to stop, change or continue treatment based on the results. These tests can also determine if cancer has returned. Whenever possible, we work to stop the growth of cancer and reduce the chance of cancer coming back. 

More support

You are not alone. Legacy offers support throughout your cancer journey, as well as care for your emotional, social and spiritual needs.

Nurse navigators
Legacy Cancer Healing Center 
Support groups and classes
Cancer rehabilitation 
Survivorship services