Treatment Overview
Receiving a diagnosis of colorectal cancer is a life-altering event that brings a mix of emotions and questions. Beyond the medical details, the condition often impacts daily life through symptoms like fatigue, changes in bowel habits, or abdominal discomfort. It can feel overwhelming to navigate the sudden influx of appointments and decisions. However, significant medical advancements have expanded the options available to manage and treat this disease effectively.
Treatment is critical to remove or destroy cancer cells, prevent the disease from spreading, and improve overall survival and quality of life. The approach is highly personalized. While early-stage cancer might be addressed primarily with surgery, medication plays a vital role in shrinking tumors before procedures, cleaning up remaining cells afterward, or managing advanced disease. Your specific treatment plan will depend on the stage of the cancer, genetic markers found in the tumor, and your general health (National Cancer Institute, 2023).
Overview of treatment options for Colorectal Cancer
The management of colorectal cancer typically involves a combination of therapies. Surgery is often the first line of defense to physically remove the tumor. However, medication-based treatments, specifically chemotherapy, targeted therapy, and immunotherapy are essential for treating cancer that has spread to lymph nodes or other organs.
For many patients, medications serve as “adjuvant therapy,” administered after surgery to lower the risk of recurrence. In other cases, they are used as “neoadjuvant therapy” to shrink a large tumor to make surgery easier. For advanced or metastatic cancer, systemic medications are the primary method to control the disease and extend life.
Medications used for Colorectal Cancer
Chemotherapy remains the backbone of treatment for many colorectal cancers. The most common drugs belong to a class called fluoropyrimidines, such as fluorouracil (often called 5-FU) or the oral pill capecitabine. These are frequently combined with other chemotherapy agents like oxaliplatin or irinotecan to increase effectiveness. Clinical experience suggests that combination regimens significantly improve survival rates in patients with higher-risk stages compared to single drugs alone.
In recent years, targeted therapies have become standard for advanced cases. These drugs target specific proteins or genes. For example, drugs like bevacizumab focus on the tumor’s blood supply. Others, like cetuximab or panitumumab, target the epidermal growth factor receptor (EGFR), though these are only effective if the patient does not have a specific genetic mutation (KRAS or NRAS).
Immunotherapy is a newer, powerful option for a specific subset of patients whose tumors have high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). Drugs known as checkpoint inhibitors, such as pembrolizumab or nivolumab, are used in these specific genetic contexts (American Cancer Society, 2024).
How these medications work
Chemotherapy drugs work by targeting fast-growing cells. They damage the DNA or RNA inside the cancer cells, which prevents them from dividing and causing them to die. Because they circulate throughout the whole body, they can attack cancer cells that have traveled away from the main tumor site.
Targeted therapies work differently by interfering with specific “switches” that cancer cells use to grow. For instance, some drugs block the growth of new blood vessels (angiogenesis inhibitors), effectively starving the tumor of the nutrients it needs to expand.
Immunotherapy does not attack the cancer directly. Instead, it helps the patient’s own immune system recognize the cancer. These drugs block proteins that act as “brakes” on immune cells. By releasing these brakes, the immune system can identify and destroy the cancer cells more effectively (Food and Drug Administration, 2022).
Side effects and safety considerations
Chemotherapy attacks fast-growing cells, including healthy ones (hair, mouth, bone marrow), causing common side effects like fatigue, nausea, diarrhea, and infection risk (low white blood cells). Oxaliplatin specifically causes neuropathy (tingling/cold sensitivity in hands/feet).
Targeted therapies have different side effects. Anti-EGFR drugs often cause an acne-like rash, which can indicate efficacy. Anti-angiogenesis drugs may cause high blood pressure or bleeding. Immunotherapy can lead to the immune system attacking healthy organs, causing inflammation in the lungs, colon, or liver.
Regular blood tests are vital to monitor liver/kidney function and blood counts. Patients must seek immediate care for fever, uncontrolled vomiting, or unusual bleeding. Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- American Cancer Society. https://www.cancer.org
- Food and Drug Administration. https://www.fda.gov
- National Cancer Institute. https://www.cancer.gov
- Mayo Clinic. https://www.mayoclinic.org
Medications for Colorectal Cancer
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Colorectal Cancer.