Treatment

TREATMENT OPTIONS BY STAGE

Colon Cancer

Stage 0 (Carcinoma in Situ)

• Local excision or simple polypectomy.
• Resection/anastomosis. This is done when the cancerous tissue is too large to remove by local excision.

Stage I

• Resection/anastomosis. 

Stage II

• Resection/anastomosis.
• Clinical trials of chemotherapy, radiation therapy, or biologic therapy after surgery.

Stage III

• Resection/anastomosis with chemotherapy.
• Clinical trials of chemotherapy, radiation therapy, and/or biologic therapy after surgery.

Stage IV and Recurrent Colon Cancer

• Resection/anastomosis.
• Surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread.
• Radiation therapy or chemotherapy may be offered to some patients as palliative therapy to relieve symptoms and improve quality of life.
• Clinical trials of chemotherapy and/or biologic therapy.

Treatment of locally recurrent colon cancer may be local excision.

Special treatments of cancer that has spread to or recurred in the liver may include the following:

• Radiofrequency ablation or cryosurgery.
• Clinical trials of hepatic chemoembolization with radiation therapy.

Patients whose colon cancer spreads or recurs after initial treatment with chemotherapy may be offered further chemotherapy with a different drug or combination of drugs.

Rectal Cancer

Stage 0

• Local excision or simple polypectomy.
• Resection. This is done when the cancerous tissue is too large to remove by local excision.
• Internal or external radiation therapy.

Stage I

• Surgery to remove the tumor with or without anastomosis.
• Surgery to remove the tumor with or without radiation therapy and chemotherapy.
• Internal and/or external radiation therapy.

Stage II

• Resection with or without anastomosis followed by chemotherapy and radiation therapy.
• Partial or total pelvic exenteration (surgery to remove the organs and nearby structures of the pelvis), depending on where the cancer has spread. Surgery is followed by radiation therapy and chemotherapy.
• Radiation therapy with or without chemotherapy followed by surgery and chemotherapy.
• Radiation therapy during surgery followed by external-beam radiation therapy and chemotherapy.
• A clinical trial evaluating new treatment options.

Stage III

• Resection with or without anastomosis followed by chemotherapy and radiation therapy.
• Partial or total pelvic exenteration (surgery to remove the organs and nearby structures of the pelvis), depending on where the cancer has spread. Surgery is followed by radiation therapy and chemotherapy.
• Radiation therapy with or without chemotherapy followed by surgery and chemotherapy.
• Radiation therapy during surgery followed by external-beam radiation therapy and chemotherapy.
• Chemotherapy and radiation therapy to relieve symptoms caused by advanced cancer.
• A clinical trial evaluating new treatment options.

Stage IV

• Resection/anastomosis to relieve symptoms caused by advanced cancer.
• Surgery to remove parts of other organs, such as the liver, lung, and ovaries, where the cancer may have spread.
• Chemotherapy and radiation therapy to relieve symptoms caused by advanced cancer.
• Chemotherapy following surgery.
• Clinical trials of chemotherapy and biological therapy.

Reference:

National Cancer Institute, USA.