Bowel cancer treatments
Everyone is different, and every cancer is different. The best treatment for any particular cancer depends on all sorts of things—such as exactly where the cancer is, how fast it's growing, how big it is, whether it has spread to other parts of the body, and the person's age and state of health.
Stages
A system called staging is used to describe how big a cancer is and how far it has spread. As well as the tests done to diagnose the cancer in the first place, other tests are done to help determine the stage. They may include blood tests, X-rays and CT scans, where a machine takes a series of X-ray pictures that are put together by a computer to get a picture of different parts of the body.
Treatments
The main treatments are surgery, radiotherapy and chemotherapy. Sometimes just one kind of treatment will be used, but often there will be 2 or even 3 types of treatment.
- Surgery
Most bowel cancers are treated by surgery. The surgeon makes an opening in the abdomen to get to the bowel. The cancer and a bit of the healthy bowel around it are removed, and the bowel is joined up again. After the operation, sometimes it's necessary to keep the faeces away from the join in the bowel so that it can heal. If this is necessary the surgeon creates an artificial opening (called stoma, colostomy or ileostomy) by bringing some bowels to the abdominal surface — so faeces has an alternative way to come out. A discreet disposable plastic bag called a colostomy bag is worn over the stoma to collect the faeces.Usually after a few months another operation is done to close the stoma or opening in the abdomen, and the faeces go along the bowel to the anus in the usual way. But sometimes this isn't possible — such as when the cancer was too close to the anus — and the stoma has to stay.
Fewer than one in 10 people who have surgery for bowel cancer needs to keep their stoma and not all need to use a colostomy bag. Other devices such as plugs can be used over the opening or stoma after the first few months.
Sometimes a very small cancer can be removed when a colonoscopy is done. Instead of just taking a part of the tumour for a biopsy, the doctor can remove the whole thing. But this is possible for only a few cancers.
- Radiotherapy
Radiotherapy, also called radiation therapy, uses X-rays or other kinds of high-energy rays to kill the cancer cells. It may be used before surgery, to shrink the tumour, or after surgery to kill any cancer cells left behind.Tests are done so that the doctor can work out the right amount of radiation to use, and where it should go. The main problem with radiotherapy and chemotherapy is that the rays can kill healthy cells as well as cancer cells.
Usually the treatment is given every weekday for 4 to 6 weeks. It doesn't hurt, and it doesn't take long — the worst part is probably hanging around the hospital, waiting.
It can have side effects (mostly temporary) including feeling sick or tired, getting diarrhoea, red or itchy skin, little marks on the skin, and pubic hair falling out. For women, periods may stop for a while, and it could mean not being able to have children in the future. It doesn't make people radioactive. It's quite safe for a person who's had radiotherapy to be around other people, including children and pregnant women.
The Cancer Council's booklet Understanding Radiotherapy talks about ways to manage side effects. Phone 13 11 20 for a copy.
- Chemotherapy
This treatment uses one or more types of drugs. They can be given as pills or injected. Usually the drugs are given for a while and then stopped before being given again, so you have a chance to recover from side effects.Some chemotherapy drugs can cause side effects such as feeling sick (which can be treated) or feeling tired. Sometimes chemotherapy causes a person's hair to fall out. It will grow back.
The Cancer Council's booklet Understanding Chemotherapy talks about ways to manage side effects. Phone 13 11 20 for a copy.
Last Reviewed: 03 January 2002
