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?
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 may have chemotherapy on its own or combined with radiation therapy (chemoradiation).
After surgery (adjuvant)
Chemotherapy may be used after surgery for either colon or rectal cancer to destroy 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.
Generally, chemotherapy is given through a drip inserted into a vein (intravenously). To reduce the need for repeated needles, you may receive chemotherapy through a device inserted beneath your skin. Examples include a port-a-cath or a peripherally inserted central catheter (PICC). Sometimes chemotherapy is taken as tablets you swallow.
Chemotherapy is commonly given as a period of treatment followed by a break. This is called a cycle. You will probably have several cycles over 4–6 months. The length of the cycle depends on the drugs used. Your medical oncologist will explain your treatment schedule. Usually, you have chemotherapy during day visits to a hospital or treatment centre. Some people have chemotherapy at home through a portable pump.
The side effects of chemotherapy vary, depending on the drugs used and the dose. Your medical oncologist or nurse will talk to you about the likely side effects, including how they can be prevented or controlled. If side effects are hard to manage, the chemotherapy treatment can be adjusted to reduce the side effects while still giving you a good result.
Side effects may include:
- feeling sick (nausea and vomiting)
- lip and mouth sores
- changes in appetite, taste and smell
- sore hands and feet (peripheral neuropathy)
- hair loss or thinning.
The chemotherapy drug oxiplatin may make your hands, feet, mouth and throat sensitive to cold items (e.g. cold food and drinks, air conditioning), causing pins and needles and numbness. Skin rash and increased sensitivity to sunburn 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).
During chemotherapy, you will have a higher risk of getting an infection or bleeding. If you have a temperature over 38°C, or the “shivers and shakes”, contact your doctor or go to the emergency department immediately. Tell your doctor if you feel more tired than usual, or if you bruise or bleed easily.
Video: What is chemotherapy?
Watch this short video to learn more about chemotherapy.
Podcast: Making Treatment Decisions
A/Prof David A Clark, Senior Colorectal Surgeon, Royal Brisbane and Women’s Hospital, QLD, The University of Queensland and The University of Sydney; Yvette Adams, Consumer; Dr Cameron Bell, Gastroenterologist, Royal North Shore Hospital, NSW; Katie Benton, Advanced Dietitian Cancer Care, Sunshine Coast University Hospital and Queensland Health, QLD; John Clements, Consumer; Dr Fiona Day, Medical Oncologist, Calvary Mater Newcastle, NSW; Alana Fitzgibbon, Clinical Nurse Consultant, GastroIntestinal Cancers, Cancer Services, Royal Hobart Hospital, TAS; Prof Alexander Heriot, Consultant Colorectal Surgeon, Director Cancer Surgery, Peter MacCallum Cancer Centre, and Director, Lower GI Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Dr Kirsten van Gysen, Radiation Oncologist, Nepean Cancer Care Centre, NSW.
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