What is the best treatment for colorectal cancer?

Colorectal / Bowel Cancer Facts

  • Men and women are affected equally by bowel cancer.
  • An estimated 16,000 people die from colorectal cancer every year in England alone.
  • Colorectal cancer is the third most common type of cancer in England.
  • Around 83% of cases of bowel cancer occur in people over 60.
  • Two-thirds of colorectal cancers develop in the colon, with the remaining third developing in the rectum.

As University College Hospital colorectal cancer expert, Mr Austin Obichere explains, "Improved survival [in bowel cancer] is dependent on the diagnosis and surgical treatment of early stage disease (no cancerous spread to the lymph glands or distant organs)". Most bowel cancers initially arise from pre-cancerous polyps which can be detected during a colonoscopy. Screening is therefore the opportunity to prevent bowel cancer developing and to treat the condition before it progresses to an advanced stage. However, some bowel cancers are inherited and a detailed family history is also required to identify those most at risk.

Early detection is the key, and so here is a summary of the symptoms:

  • blood in stools or bleeding from the rectum
  • a change to normal bowel habits that persists for more than six weeks
  • abdominal pain
  • unexplained weight loss

The normal course of events for managing colorectal cancer is:

  1. Diagnosis of suspected colorectal cancer
  2. Staging of the disease
  3. Management of both local and metastatic disease
  4. Follow-up and regular surveillance for those free from disease after treatment

But what is the best level of care that you should expect to receive? The answer according to the latest National Institute of Health and Clinical Excellence (NICE) guidance consists of the following recommendations:

  1. People with suspected colorectal cancer without any other significant diseases are to be offered a colonoscopy.
  2. Anyone diagnosed with colorectal cancer is to be offered a CT scan of the chest, abdomen and pelvis to estimate the spread of the disease and an MRI to assess the risk of the cancer returning.
  3. People with rectal cancer are to be offered treatment before surgery that takes into account the likelihood of the cancer returning. 
  4. Patients with stage 2 colorectal cancer should be offered further surgery or active monitoring if the healthy tissue around the tumour is thought to contain cancer cells.
  5. People with colorectal cancer that may have spread to the liver will have their CT scans reviewed by the hepatobiliary multidisciplinary team to decide if further scans are needed to guide the choice of treatment.  
  6. People with colorectal cancer that has spread to other parts of the body and continued to spread after initial chemotherapy are to be offered additional chemotherapy and/or treatment with a type of drug called a biological therapy.
  7. People with colorectal cancer who are disease free after treatment should be offered regular check-ups and investigations to check for any signs of the disease returning.
The part of the body that contains the stomach, intestines, liver, gallbladder and other organs. Full medical glossary
Relating to the abdomen, which is the region of the body between the chest and the pelvis. Full medical glossary
A fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. Full medical glossary
A common name for the large and/or small intestines. Full medical glossary
Abnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body. Full medical glossary
Malignant, a tumour that may invade surrounding tissues or spread to distant parts of the body. Full medical glossary
The basic unit of all living organisms. Full medical glossary
The use of chemical substances to treat disease, particularly cancer. Full medical glossary
The large intestine. Full medical glossary
Examination of the colon and rectum with a colonoscope, an imaging instrument that is inserted through the anus. Full medical glossary
The abbreviation for computed tomography, a scan that generates a series of cross-sectional x-ray images Full medical glossary
The process of determining which condition a patient may have. Full medical glossary
An organ with the ability to make and secrete certain fluids. Full medical glossary
intermittent claudication Full medical glossary
A large abdominal organ that has many important roles including the production of bile and clotting factors, detoxification, and the metabolism of proteins, carbohydrates and fats. Full medical glossary
A watery or milky bodily fluid containing lymphocytes, proteins and fats. Lymph accumulates outside the blood vessels in the intercellular spaces of the body tiisues and is collected by the vessels of the lymphatic system. Full medical glossary
An abbreviation for magnetic resonance imaging, a technique for imaging the body that uses electromagnetic waves and a strong magnetic field. Full medical glossary
Relating to a group of healthcare professionals with different areas of specialisation. Full medical glossary
The bony basin formed by the hip bones and the lower vertebrae of the spine; also refers to the lower part of the abdomen. Full medical glossary
A growth on the surface of a mucous membrane (a surface that secretes mucus, lining any body cavity that opens to the outside of the body). Full medical glossary
Growths on the surface of a mucous membrane (a surface that secretes mucous), lining any body cavity that opens to the outside of the body. Full medical glossary
Relating to the rectum, the lowest part of the bowel leading to the anus. Full medical glossary
The last part of the large intestine, where faeces are stored before being passed. Full medical glossary
A group of cells with a similar structure and a specialised function. Full medical glossary
An abnormal swelling. Full medical glossary