Treatment Overview
Treatment for metastatic or recurrent colorectal cancermetastatic or recurrent colorectal cancer is based on many things. These include the location of the cancer, your overall health, and what matters to you. The main treatments are surgery, chemotherapy, or both. Other treatments may be used, such as targeted therapy or immunotherapy. If cancer has spread to the liver, you may have other options. Examples include thermal ablation and embolization. A clinical trial may be a good choice.
Your doctor will talk with you about your options and then make a treatment plan.
Some people use complementary therapiescomplementary therapies along with medical treatment. Therapies like acupuncture or massage may help you cope with the symptoms and stress of having cancer. Talk with your doctor about any of these options you would like to try.
Surgery
Surgery may be an option if the doctor thinks all of the cancer can be removed. You may have surgery to remove cancer in the colon or rectum. Or the doctor may remove cancer that has spread to the liver or lungs.
Sometimes surgery is done to relieve symptoms. For example, the doctor may create a colostomycolostomy to ease symptoms caused by a tumor that's blocking the colon. If you need a colostomy, you will get help from a nurse who specializes in ostomy care.
Chemotherapy and other medicines
Chemotherapy is the main treatment if surgery is not an option. These medicines kill fast-growing cells, including cancer cells and some normal cells. In some cases, the medicines are used to shrink a tumor before surgery. They may also be given after surgery to destroy any cancer cells that remain.
You may have testing to find out if the cancer has certain tumor markerstumor markers (biomarkers). This can help your doctor choose the best chemotherapy medicines for you. It can also help the doctor know if other medicines may help. These include:
- Targeted therapy.
- These medicines target cancer cells and may cause less harm to normal cells. They help keep cancer from growing or spreading.
- Immunotherapy.
- This treatment helps your immune system fight cancer. It may be given in several ways.
Chemotherapy, targeted therapy, and immunotherapy may be given together.
These medicines are often put into a vein. Sometimes they are taken as a pill. The medicines travel through your body to kill cancer cells both inside and outside the bowel area.
Radiation therapy
This uses high-dose X-rays to destroy cancer cells and shrink tumors. It may be given during surgery or combined with chemotherapy (chemoradiation).
Radiation therapy may be used to shrink a tumor that's blocking the colon or rectum. It can also help relieve symptoms such as bleeding or pain.
Radiation therapy is often given by a machine outside the body (external radiation). It may also be given by placing substances inside the body (internal radiation, or brachytherapy).
Treatment for metastatic cancer in the liver
Sometimes surgery can remove colorectal cancer that has spread to the liver. But usually other treatments are needed. Other options include:
- Thermal ablation.
- This uses extreme cold or heat to destroy tumors. Cryosurgery (or cryotherapy) is a type of ablation that uses cold. Radiofrequency ablation uses heat.
- Embolization.
- This treatment uses tiny beads to block blood flow to a tumor. This help shrinks the tumor. The beads may give off radiation or chemotherapy. Or chemotherapy may be injected into the blood vessel before it's blocked.
- Chemotherapy.
- To treat tumors in the liver, chemotherapy may be given through a vein. Or the medicine may be put directly into an artery in the liver (intra-arterial chemotherapy).
- Radiation therapy.
- Radiation therapy may be given in different ways. One type is called stereotactic radiation therapy. It uses high doses of radiation focused right on the tumor. This helps to limit damage to normal tissues.
Clinical trials
Clinical trials are an option for many people who have colorectal cancer. These research studies test promising new treatments or improvements to existing treatments. People in clinical trials may have access to the latest treatments before they're available to others.
Your medical team can tell you if there's a clinical trial that might be right for you.
Learn more
- Bowel Resection for Colorectal CancerBowel Resection for Colorectal Cancer
- Clinical TrialsClinical Trials
- ColostomyColostomy
- Immunotherapy for CancerImmunotherapy for Cancer
- Radiation Therapy for Cancer PainRadiation Therapy for Cancer Pain
- Radiation Treatment for CancerRadiation Treatment for Cancer