Chemotherapy for bowel cancer

Chemotherapy may be used at different times:

Before surgery (neo-adjuvant)

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

After surgery (adjuvant)

Chemotherapy is used after surgery for either colon or rectal cancer to reduce the chance of the cancer coming back by eliminating any cancer cells that may have spread after surgery. You will probably start chemotherapy as soon as your wounds have healed and you’ve recovered your strength, usually within eight weeks.

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

You may have chemotherapy injected into a vein (intravenously) or as tablets.

Intravenously – The drugs are injected through a thin plastic tube called a central venous access device (CVAD). The CVAD may be placed under the skin with a local anaesthetic. This type of CVAD is called a port-a-cath.

Infusor pump – Some people have chemotherapy through a portable bottle called an infusor pump. It is made of hard plastic and looks like a baby bottle. It is usually worn in a bag around your waist or on your hip. The bottle gives a continuous dose over 48 hours while you are at home. You will be shown how to care for the 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.

Most chemotherapy drugs cause some side effects. The side effects depend on the drugs used and the dosage levels.

Common side effects include:

• tiredness
• feeling sick (nausea and vomiting)
• diarrhoea
• mouth sores and ulcers
• changes in appetite and loss of taste
• a drop in levels of blood cells (your blood count), which may increase the risk of infection
• sore hands or feet
• pins and needles, numbness, redness or swelling in the fingers and toes – more common if using the chemotherapy drug called oxaliplatin
• skin peeling and increased sensitivity to sunlight – more common if using the chemotherapy drug called fluorouracil (or 5-FU).

People react to chemotherapy differently – some people have few side effects, while others have many. Most side effects are temporary, and there are ways to prevent or reduce them. Your doctor will prescribe medication to prevent and manage the side effects. It is uncommon to need a break or change in your treatment.

Keep a record of the doses and names of your chemotherapy drugs handy. This will save time if you become ill and need to visit the emergency department.

For more information, call 13 11 20 and ask for a copy of Understanding Chemotherapy, or download a digital version from this page.

Watch this short video to learn more about chemotherapy.