Chemotherapy for Colorectal Cancer
Chemotherapy uses drugs to destroy colorectal cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Chemotherapy may be used:
- Before surgery—to shrink the tumor and decrease the amount of tissue that needs to be removed
- After surgery—to kill any remaining cancer cells and decrease the risk of return
- In combination with radiation therapy to shrink tumor
- To help relieve symptoms of metastatic cancer and extend survival time
Chemotherapy Drugs and Delivery
There are a variety of chemotherapy drugs. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for colorectal cancer may include:
- 5-Fluorouracil (5-FU) with or without leucovorin or oxaliplatin
- Capecitabine with or without oxaliplatin
- Trifluridine and tipiracil
Chemotherapy for colorectal cancer is usually given through an IV, but some forms can be given by mouth. It is delivered in cycles over a set period of time. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.
Side Effects and Management
Though the drugs are targeted to cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:
- Increased frequency and urgency of bowel and bladder function
- Numbness, pain, or burning sensation in the the hands and feet—peripheral neuropathy
- Nausea and vomiting
- Fatigue due to anemia
- Confusion, forgetfulness
A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.
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