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Treatment

If a doctor finds bowel cancer on biopsy, she or he will want to learn the stage (or extent) of disease. Treatment will depend in part on the stage of the bowel cancer, that is, how far it has spread from its original site.

Staging systems for bowel cancer and the terms used by them vary in different parts of the world, and the most widely accepted systems of staging rely on the extent of spread. In Australia, the staging system for bowel cancer is the Australian Clinico-Pathological Staging (ACPS) System also known as Duke's System.

Stage A – the cancer is confined to the bowel wall
Stage B – the cancer has spread to the outer surface of the bowel wall
Stage C – the cancer is found in lymph nodes near the bowel
Stage D – the cancer is found at distant sites, for example the liver or lungs.

Another commonly used staging system is TNM (Tumour Nodes Metastasis).  This system defines the extent of Tumour invasion (T1 to T4), number of local lymph Nodes affected by the tumour (N0 to N2), and whether the tumour has spread to a distant site or not (termed Metastasis – M0 or M1).

Further details on staging can be found on the Bowel Cancer Australia web site.

All stages of bowel cancer are usually treated by surgically removing the cancer and possibly some of the surrounding tissue. For Stages B and C, chemotherapy and/or radiation therapy may be added to help kill the cancer and shrink the tumour. Chemotherapy and radiation may also be used in Stage D to improve symptoms and to prolong life.

Targeted therapy is a relatively new approach to treatment that uses drugs to target specific proteins that control cell growth and maturation. Malfunctioning proteins may contribute to a cancer's uncontrolled growth. For example, drugs such as cetuximab attack the epidermal growth factor receptor (EGFR). Targets therapies such as these may have less severe side effects than standard chemotherapy.

Immunotherapy is also relatively new and may be used to treat some patients with colon cancer. Immunotherapy works by helping a patient's own immune system recognise and kill cancer cells more effectively.


Last Review Date: November 28, 2018