Chemotherapy for bowel cancer

Chemotherapy uses drugs to kill or slow the growth of cancer cells while doing the least possible damage to healthy cells.

Learn more about:

• When chemotherapy is used
• Having chemotherapy
• Side effects of chemotherapy
• Video: What is chemotherapy?

When chemotherapy is used

If the cancer has spread to lymph nodes or to other organs, chemotherapy may be recommended before or after surgery or on its own.

Before surgery (neoadjuvant) 

Some people with rectal cancer have chemotherapy before surgery to shrink the tumour and make it easier to remove. You are likely to have chemotherapy together with radiation therapy (chemoradiation) for rectal cancer.

After surgery (adjuvant) 

Chemotherapy may be used after surgery for either colon or rectal cancer to kill any remaining cancer cells and reduce the chance of the cancer coming back. If your doctor recommends chemotherapy, you will probably start treatment as soon as your wounds have healed and you’ve recovered your strength, usually within 6–8 weeks.

On its own 

If the cancer has spread to other organs, such as the liver or lungs, chemotherapy may be used either to shrink the tumours or to reduce symptoms and make you more comfortable.

Having chemotherapy

You may have chemotherapy through a liquid drip into a vein (intravenously) or as tablets. It may also be given through a thin plastic tube called a central venous access device, such as a PICC (peripherally inserted central catheter) line. Some people have chemotherapy at home through a portable bottle called an infusor pump. You will probably have chemotherapy as a course of several sessions (cycles) over 4–6 months. Your medical oncologist will explain your treatment schedule. You’ll have regular scans to monitor your response to the chemotherapy.

Side effects of chemotherapy

People react to chemotherapy differently – some people have few side effects, while others have many. The side effects depend on the drugs used and the dose. Your medical oncologist or nurse will discuss the likely side effects with you, including how they can be prevented or controlled with medicine. The chemotherapy treatment can be adjusted to give you a good result while reducing side effects.

Side effects occur when chemotherapy damages healthy, fast-growing cells. They include:

• tiredness
• feeling sick (nausea and vomiting)
• diarrhoea
• mouth sores and ulcers
• changes in appetite, taste and smell
• sore hands and feet
• hair loss or thinning
• more likely to catch infections.

Pins and needles, numbness, redness or swelling in the fingers and toes are more common if using the chemotherapy drug called oxaliplatin. Skin peeling and increased sensitivity to sunlight are more common if using the chemotherapy drug called fluorouracil (or 5-FU).

Keep a record of the doses and names of your chemotherapy drugs handy. This will save time if you get an infection and need to visit the emergency department (see below).

For more on this, see Chemotherapy and Managing cancer side effects.

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.