There are three main forms of treatment for colorectal cancer available today:

Surgery
Radiotherapy
Chemotherapy

Surgery aims to completely remove the cancer from its original site and usually
also remove the lymph nodes around the colon and rectum in order to prevent
recurrence.

Also surgery can remove metastases from the liver, lungs etc. and can resolve
problems caused by the cancer such as intestinal obstruction.

Radiotherapy is used only for cancer of the rectum and not the colon. This is
because although the pelvis (where the rectum lies) can be irradiated with few
side effects, it is not generally possible to irradiate the abdomen (where the colon
lies) without causing serious side effects.

Radiotherapy can be used in two ways:

Pre-operative radiotherapy- when a rectal tumour is too large and bulky. In those
cases most doctors prefer to irradiate the tumour in order to make it shrink to a
size that can be removed with subsequent surgery.

If pre-operative radiotherapy is indicated then the duration of the treatment is for
6-8 weeks. After that it is necessary to have an interval of 4 weeks prior to
surgery.

Post-operative radiotherapy when, although the tumour has been removed, the
histological examination shows that there might be remaining cancer cells in that
area.

The decision on how to use radiotherapy is taken by the multi-disciplinary team
after completion of the staging investigations.

Chemotherapy is also used either pre-operatively, in combination with
radiotherapy, or post-operatively.

Chemotherapy and radiotherapy given after surgery for prevention of recurrence
is called adjuvant treatment. If the same treatment is given pre-operatively then it
is called neo-adjuvant treatment.


The decision on the planning of treatment is complex and full assessment of all
the patients’ staging investigations has to be made. The decision is made by the
multi-disciplinary team.

In the UK since 1997 it is obligatory for all hospitals which treat colorectal cancer
to have multi-disciplinary teams in order to make these complex decision
treatments.
A typical multi-disciplinary team consists of surgeons, oncologists,
gastroenterologists, radiologists, histopathologists, palliative care doctors, nurse
specialists and an administrative co-ordinator.




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Treatments for Colorectal Cancer and
planning of treatment