Colon Cancer Treatment

Treatment at MD Anderson’s Gastrointestinal Center combines the latest technology and research with a multidisciplinary team approach tailored to your unique needs.

Our team of surgeons use minimally invasive techniques, including advanced robotic surgery, that reduce recovery time and maximize quality of life. MD Anderson also offers clinical trials for patients at every disease stage, from newly diagnosed small tumors to patients with stage IV cancer.

Colon cancer treatment plans

Colon cancer that has not spread to distant parts of the body is usually treated with surgery. Some patients then receive chemotherapy or, less commonly, radiation therapy to kill any remaining cancer cells.

If colon cancer has spread, or metastasized, to distant parts of the body, some patients can still be cured. For others, the disease is managed like a chronic condition and care is meant to prolong and preserve quality of life. Treatments for all patients with metastatic colon cancer can include surgery, radiation therapy, and cancer drugs like chemotherapy and targeted therapy.

Surgery  

Surgery is the most common treatment for colon cancer, especially if it has not spread. Like many cancers, surgery for colon cancer is most successful when done by a surgeon with a great deal of experience in the procedure. At MD Anderson, colon cancer surgery is performed by surgeons who are specialized in colon cancer surgery and are national and international leaders in the field. Surgeons around the country often refer their patients to MD Anderson surgeons for their expertise, especially for the most difficult cases.

Many colon cancer surgeries can be performed using minimally invasive techniques, such as robotic or laparoscopic surgery. These procedures require only a few small cuts. They offer less pain and faster recovery time compared to traditional open surgery. Surgeons at MD Anderson specialize in performing advanced robotic minimally invasive surgery.

Depending on the tumor’s size and location, patients may not be able to have normal bowel movements after surgery. This can be either temporary or permanent. In these cases, waste in the colon is diverted through an opening in the abdomen and into an external bag. This procedure, called a colostomy, is performed at the same time as the surgery to remove the tumor.

The type of surgery colon cancer patients undergo depends on the stage and location of the tumor. They include:

Polypectomy: A colonoscope, which is a long tube with a camera on the end, is inserted into the rectum and guided to the polyp. Tiny tools or a wire loop removes the polyp. A polypectomy is ideal for very early, low-risk cancers found within polyps and is usually performed during colonoscopy.

Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD): If a polyp is too large to be removed by traditional polypectomy, an EMR or ESD may be performed. The doctor will use small instruments inserted through a colonoscope to perform detailed surgery from inside the rectum. The polyp and some surrounding tissue will be removed. With this type of advanced endoscopic procedure, major surgery can sometimes be avoided. Gastroenterologists at MD Anderson are experts at performing these specialized, advanced endoscopic procedures.

Colectomy: In a colectomy, the section of the colon affected by cancer, some healthy surrounding tissue and all of the associated lymph nodes are removed. The lymph nodes are then analyzed under a microscope for the presence of cancer cells.

Determining what section of bowel and lymph nodes to take out, and successfully removing them, is the most important factor in the patient’s outcome. Surgeons carefully evaluate the blood supply to the area to make these decisions. After removal, the surgeon connects the remaining sections of the colon back together. This surgery, also called a hemicolectomy or partial colectomy, can generally be performed with minimally invasive techniques.

Multiorgan resection for locally advanced cancers: If a patient’s cancer has spread to other nearby organs, they may be surgically removed along with the rectum. Organs that are commonly removed include the bladder, prostate, seminal vesical, ovaries and uterus.

Metastectomy: If colon cancer has spread to other parts of the body such as the lung, liver, ovaries or distant lymph nodes, it may be possible to perform surgery to remove those tumors. At MD Anderson, a multidisciplinary team of doctors including surgeons, medical oncologists and radiation oncologists performs a detailed review to make the recommendation for the best option for treatment when metastasis is identified.

Peritoneal cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Colon cancer can spread into the abdominal cavity. During peritoneal cytoreductive surgery, the surgeons remove all visible tumors from the lining of the abdomen. In some cases, this procedure is paired with Hyperthermic Intraperitoneal Chemotherapy, or HIPEC. HIPEC involves filling the abdominal cavity with chemotherapy drugs that have been heated. Also known as “hot chemotherapy,” HIPEC is performed after the surgeon removes tumors or lesions from the abdominal area. Learn more about HIPEC.

Chemotherapy

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing. 

• Learn more about chemotherapy

Targeted Therapy

Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.  

• Learn more about targeted therapy

Radiation therapy

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.

Radiation therapy is used in select cases to ease colon cancer symptoms. It can also treat metastases when the disease has spread to just a few spots in the body.

• Learn more about radiation therapy

Immunotherapy

The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system’s ability to eliminate cancer. 

• Learn more about immunotherapy

There are two types of immunotherapy currently used to treat colon cancer:

• Immune checkpoint inhibitors stop the immune system from turning off before cancer is completely eliminated. 
• Monoclonal antibodies attach to specific proteins on the surface of cancer cells or immune cells. They either mark the cancer as a target for the immune system or boost the ability of immune cells to fight the cancer.

Angiogenesis inhibitors 

Angiogenesis is the process of creating new blood vessels. Some cancerous tumors are very efficient at this process. New blood vessels increase blood supply to a tumor, allowing it to grow rapidly. Angiogenesis inhibitors, or anti-angiogenic therapy, disrupt the creation of these blood vessels.  

• Learn more about angiogenesis inhibitors

Clinical trials

Clinical trials are a key component of MD Anderson's mission to end cancer. Patients may volunteer to participate in these research studies, which help doctors improve cancer prevention, diagnosis and treatment. 

Some clinical trials allow patients to receive experimental medications or treatments, though not all patients are eligible.

If you're interested, ask your doctor if you might be a candidate for a clinical trial.
 

• Learn more about clinical trials