Treatment of colorectal cancer includes:

1. Radiotherapy-Use of x-rays to kill cancer cells- rectal cancers
2. Chemotherapy- use of drugs to kill cancer cells

Stage I

Stage I bowel cancer means that the cancer has grown through the inner lining of the bowel, or into the muscle wall, but no further. There is no cancer in the lymph nodes

Treatment for stage 1 large bowel (colon) cancer

Surgery is the main treatment. In early bowel cancer chemotherapy is not usually needed.

Treatment for stage 1 Rectal cancer

The main treatment is surgery to remove the cancer.

Types of surgeries that can be done include:

• trans anal endoscopic microsurgery (TEM) – the surgeon removes the cancer along with a border (margin) of healthy tissue (you have this if you have a very early stage, low risk cancer)
• total mesorectal excision (TME) – the surgeon removes the part of the rectum that contains cancer, as well as a border (margin) of healthy tissue around it, and the fatty tissue (mesorectum) around the rectum

Stage 2

Stage 2 bowel (colon and rectal) cancer has spread into the outer wall of the bowel or into tissue or organs next to the bowel. It has not spread to the lymph nodes or distant parts of the body.

Treatment for stage 2 colon cancer

Surgery then followed by chemotherapy to reduce chances of cancer coming back.

Treatment for stage 2 rectal cancer

• – surgery as the only treatment, or followed by chemoradiotherapy if the risk of cancer coming back is higher than the surgeon previously thought
• – a short course of radiotherapy, followed by surgery
• – a course of chemoradiotherapy, followed by surgery

Stage 3 

Stage 3 bowel (colon and rectal) cancer has spread to nearby lymph nodes, but hasn’t spread to distant body parts.

Treatment for stage 3 Colon cancer

Surgery to remove the cancer. Most people have chemotherapy after surgery.

Treatment for stage 3 Rectal cancer

• – surgery as the only treatment, or followed by chemoradiotherapy if the risk of cancer coming back is higher than the surgeon previously thought
• – a short course of radiotherapy, followed by surgery
• – a course of chemoradiotherapy, followed by surgery

Stage 4 

Stage 4 bowel (colon and rectal) cancer means the cancer has spread to other parts of the body, such as the liver or lungs. It’s also called advanced bowel cancer.

Treatment for stage 4 colon cancer

The doctor may recommend chemotherapy to downstage the tumor then surgery.

Or surgery first then chemotherapy

Treatment for stage 4 Rectal cancer

The doctor may recommend chemotherapy then surgery

Or chemotherapy and radiotherapy