Treatment options
There are several ways to treat bowel cancer. Your treatment plan will be tailored to you, based on the type, stage, and location of your cancer.
Every treatment plan is different
Your treatment depends on the stage of your cancer, where it is in the bowel, your overall health, and your preferences. Your care team will recommend a plan based on all of these factors. You don't have to decide alone – and you can always ask for a second opinion.
Understanding your options
Surgery
Surgery is the most common treatment for bowel cancer. The goal is to remove the section of bowel that contains the cancer, along with nearby lymph nodes. For early-stage cancers, surgery may be the only treatment needed.
When it's used: Most stages of bowel cancer. Often the first step in treatment.
Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy cancer cells. It can be given before surgery (to shrink the tumour), after surgery (to reduce the chance of it coming back), or as a main treatment for advanced cancer.
When it's used: Stage III and some stage II cancers after surgery. Advanced cancers. Sometimes before surgery for rectal cancer.
Radiation therapy
Radiation therapy (radiotherapy) uses high-energy beams to kill cancer cells. It's most commonly used for rectal cancer, often in combination with chemotherapy before surgery to shrink the tumour and make it easier to remove.
When it's used: Rectal cancer (often before surgery). Sometimes used to manage symptoms in advanced cancer.
Targeted therapy
Targeted therapies are drugs that specifically target features of cancer cells. Unlike chemotherapy, they aim to attack cancer cells while causing less damage to normal cells. Common examples include bevacizumab (Avastin) and cetuximab (Erbitux).
When it's used: Advanced bowel cancer, usually combined with chemotherapy. Depends on the genetic characteristics of your tumour.
Immunotherapy
Immunotherapy helps your immune system recognise and attack cancer cells. It works particularly well for cancers with specific genetic features, such as microsatellite instability (MSI-high) or mismatch repair deficiency (dMMR).
When it's used: Advanced bowel cancer with MSI-high or dMMR features. Your oncologist will test for this.
Clinical trials
Clinical trials give you access to new treatments that aren't yet widely available. New Zealand has a number of active bowel cancer trials. Your oncologist can advise whether a trial might be right for you.
When it's used: Various stages, depending on the trial. Ask your specialist about what's available.
Combination treatments
Many people receive a combination of treatments. For example, you might have chemotherapy and radiation before surgery, or chemotherapy after surgery. Your care team will explain why they recommend a particular combination for you.
What if treatment isn't working?
If your current treatment isn't having the desired effect, your team may adjust your plan. This could mean switching to a different chemotherapy regimen, adding a targeted therapy, or exploring clinical trials. It's important to keep communicating with your team about how you're feeling.
Next steps
Learn more about specific treatments or talk to your care team about what's right for you:
Questions about treatment?
Our free nurse support line can help you understand your options and prepare for appointments. Call 0800 226 968.