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Colon cancer nurse and patient

Getting started

Your treatment begins with your Legacy Cancer Institute doctor recommending a plan based on expert guidelines, called protocols. Your treatment is determined by:

  • The type of tumor
  • The location of the tumor
  • The extent of the disease, called the stage
  • Any tests you have had during diagnosis
  • A discussion about what is right for you

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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. 

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.  

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.

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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

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