Chemotherapy for colorectal cancer

Chemotherapy is treatment with cytotoxic drugs that are given either intravenously (IV) or by mouth (pills). Cytotoxic drugs are toxic to cancer cells. These drugs travel through the bloodstream and keep cancer cells from growing, dividing, and making more cells.

Because chemotherapy (chemo) travels through the whole body, it can also damage healthy cells. This is why some chemo drugs can cause side effects such as hair loss, mouth sores, and nausea.

Chemotherapy is used to treat both colon and rectal cancer.

The goals of chemotherapy for colorectal cancer depend on the stage and location of the cancer.

Chemotherapy may be given alone or as a part of a treatment plan that includes other types of treatments.

Chemo may be given at different times during treatment, including:

• As primary treatment (curative chemotherapy): Chemo that is given to get rid of cancer and prevent it from coming back.
• Before other treatments (neoadjuvant chemotherapy): Chemo that is given before surgery or radiation therapy to shrink tumors.
• After other treatments (adjuvant chemotherapy): Chemo that is given after surgery or radiation therapy to destroy any remaining cancer cells.

Palliative chemotherapy

Even when cancer is not curable, your doctor may still recommend chemotherapy to improve quality of life. Chemo can sometimes slow the progression of the cancer, relieve cancer-related pain and discomfort, and extend survival.

Because colorectal cancer chemotherapy often damages healthy cells and tissues, side effects are common.

Many patients fear the side effects from treatment more than the cancer itself, but there are some things to keep in mind:

• Side effects depend mainly on the type and extent of the chemotherapy.
• Your side effects may not be the same as someone else’s.
• Your side effects may change from one treatment session to the next.

In the past, chemotherapy side effects were a very difficult part of cancer treatment. However, today there are a number of effective ways to manage these with medication and other methods.

Learn how to cope with common chemo side effects:

5-FU and Xeloda (capecitabine) are two of the most commonly used chemotherapy drugs for colorectal cancer. The FDA and NCCN recommend that all patients prescribed 5-FU or Xeloda be tested for DPD activity before starting treatment unless immediate treatment is necessary. Although most people have normal DPD activity, decreased DPD activity can lead to possible side effects including death. If you have not been tested for DPD activity and have started treatment with 5-FU or Xeloda, our side effects and symptoms guide provides an overview of potential side effects you may experience if your DPD activity is decreased.  It is a good idea to keep this guide handy during your treatment with these drugs.