Colon cancer

Treatment

Fred Hutchinson Cancer Center experts offer comprehensive care for colon cancer, including advanced treatments and new options available only through clinical studies.

Many patients are seen at our Colorectal Cancer Specialty Clinic. At this clinic, all of the specialists who will be involved in your care will meet to design treatment that’s tailored to you. You will receive a multidisciplinary treatment plan in a single day — truly one-stop shopping.

Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

Our goal is to see you within one week so you can start your treatment quickly.

A diagnosis of cancer can feel overwhelming. We have an experienced, compassionate team ready to help.

There are many similarities between colon cancer and rectal cancer, but there are some differences in the ways they are usually treated. Learn about rectal cancer treatment.

Colon cancer expertise at Fred Hutch

Colon cancer survival rates

Data collected from cancer centers across the country show that people who begin their colon cancer treatment at Fred Hutch have higher survival rates on average than those who started treatment at other centers.

Everything you need is here

We have surgeons, medical oncologists and pathologists who specialize in colorectal cancer; the most advanced diagnostic, treatment and recovery programs; and extensive support.

Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope.

Innovative colon cancer therapies

Fred Hutch patients have access to advanced therapies being explored in clinical studies for colon cancer conducted here and at our founding organizations Fred Hutchinson Cancer Research Center and UW Medicine.

Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease.

Colon cancer treatment tailored to you

We view treatment as a collaborative effort. Your Fred Hutch doctors will explain all your options and recommend a treatment plan to get you the best results based on the stage, size and location of your cancer and your overall health.

Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

Team-based approach

Your personal team includes more than your colon cancer doctors. Additional experts who specialize in treating people with cancer will be involved if you need them — experts like a geneticist, genetic counselor, dietitian, pharmacist, social worker or palliative care professional.

Learn More About Our Supportive Care Services

Genetic counselor A health care professional with special training in medical genetics and counseling. Genetic counselors help patients and families who have, or who may be at risk of, a genetic condition. A health professional who has special training in medical genetics and counseling. Genetic counselors help patients and families who have, or who may be at risk of, a genetic condition. They help patients find out their chances of having a genetic condition or of having a child or other family member with a genetic condition. They also help patients understand their options for genetic testing, including its risks and benefits. After genetic testing is done, genetic counselors help patients understand their test results, including how the results can affect other family members. They also provide counseling and support.

Ongoing care and support

During and after treatment, your team continues to provide follow-up care on a schedule tailored to you. The Fred Hutch Survivorship Clinic is also here to help you live your healthiest life as a colon cancer survivor.

Learn More About the Fred Hutch Survivorship Clinic

Treatment types

Treatment looks different for different people depending on your diagnosis. We tailor your treatment plan to you. Learn more about the treatment types offered at Fred Hutch.

Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.

Surgery

Most people with colon cancer begin treatment by having surgery to remove their cancer. If colon cancer has spread (metastasized) to another area, doctors typically start with chemotherapy to treat all sites of disease. After chemo, they may recommend surgery if the metastases have responded and can be surgically removed.

As an Fred Hutch patient, you’ll have surgery performed by a UW Medicine surgeon specially trained and board certified in colorectal surgery.

Your exact procedure will depend on factors like the stage of your cancer and your overall health, weight and preferences. You and your team will discuss your options and decide together what is best for you.

Our surgeons use minimally invasive techniques whenever possible and follow evidence-based guidelines to enhance your recovery (“early-recovery after surgery” protocols).

Polypectomy

If your cancer is limited to one or more polyps, it may have been completely removed during your colonoscopy.

Colectomy

If a polypectomy is not enough or is not possible, your surgeon will remove the segment of your colon that contains cancer.

Your surgeon will also check whether cancer has spread to other organs (which will include removing nearby lymph nodes).
Whenever possible, we perform colectomies laparoscopically (through small “keyhole” incisions). Smaller incisions typically mean a shorter hospital stay and less need for pain medication.
If laparoscopic surgery isn’t possible, your surgery will be done through a single, longer incision in your abdomen.

Reconstructive surgery

During surgery to treat colon cancer, some patients need reconstruction of the pelvis or perineum. The type of reconstruction depends on the exact surgery being done for the cancer. If needed, our skilled reconstruction team will cover and close the perineal area or place tissue in the pelvis. This is done using tissue from another area of your body (flap reconstruction), typically the abdomen or thigh. Our colorectal and reconstructive surgeons often work together to do both resection (removal of the cancer) and reconstruction during the same surgery.

Learn More About Reconstructive Surgery

Colostomy

Some people need a temporary or permanent colostomy. The surgeon creates an opening (stoma) in your abdomen and attaches the open end of your colon to it on the inside. A bag is attached on the outside to collect waste.

We can help you learn how to care for your colostomy and adjust so you can go on with normal activities comfortably. We have a specially certified wound ostomy nurse who understands the physical and emotional impact of ostomies and can work closely with you, your family and your doctors. Our survivorship clinic also plays an integral part in your ongoing care.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Colostomy An opening into the colon from the outside of the body. A colostomy provides a new path for waste material, such as urine and feces, to leave the body after part of the colon has been removed. Colonoscopy An examination of the inside of the colon using a colonoscope, which is inserted into the rectum. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. An examination of the inside of the colon using a colonoscope, which is inserted into the rectum. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Laparoscopic surgery A surgery done with the aid of a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Surgery done with the aid of a laparoscope. A laparoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. perineum The area of the body between the anus and the vulva in females, and between the anus and the scrotum in males.

Surgery

Chemotherapy

Your doctors may recommend chemotherapy:

After surgery to help prevent your cancer from coming back
As your first treatment, instead of surgery, if your cancer has already spread to another area at the time it is diagnosed

Usually chemotherapy medicines are given by infusion into a vein. Some are taken by mouth in pill form.

Your Fred Hutch team will talk with you about the specific drugs we recommend for you, how you’ll receive them, your treatment schedule and what to expect. We’ll also explain how to take the best possible care of yourself during treatment and after, and we’ll connect you with medical and support resources throughout Fred Hutch.

Chemotherapy

Your doctors may recommend chemotherapy after surgery to help prevent your cancer from coming back or as your first treatment, instead of surgery, if your cancer has already spread to another area at the time it is diagnosed.

Targeted therapy

Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. They target a gene or protein responsible for allowing cancer to grow, they seek out and damage cancer cells, or they prompt your immune system to attack particular cells (also called immunotherapy).

Targeted biological therapies use substances, like antibodies, that come from living organisms, or versions of these substances made in a laboratory.

These medicines are important if you have colorectal cancer that has spread to other parts of your body (advanced or metastatic cancer).

Biological therapies for colorectal cancer include:

Bevacizumab (Avastin) — which starves tumors by stopping growth of blood vessels that nourish tumor cells (anti-angiogenesis therapy)
Cetuximab (Erbitux) and panitumumab (Vectibix) — which block a normal protein (epidermal growth factor receptor) on the surface of your cells that may contribute to cancer growth (anti-EGFR therapies, or EGFR inhibitors)

Antibody A protein made by immune system cells and released into the blood. Antibodies defend the body against foreign substances, such as bacteria. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Gene The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Metastatic A metastatic cancer is a cancer that has spread to other areas of the body by way of the lymph system or bloodstream. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies.

Targeted therapy

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

This treatment is for people with colon cancer that has spread to the abdominal lining (peritoneum). Cancer that has spread here is called peritoneal carcinomatosis, or peritoneal cancer.

CRS-HIPEC may be able to control advanced disease while also giving you good quality of life. It combines two parts in one operation:

A surgery to remove all the cancer that surgeons can see
Chemotherapy, in liquid form, that is warmed and then put into your abdomen to kill any cancer cells left behind after surgery

Fred Hutch has an experienced team that provides CRS-HIPEC.

Learn More

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

This treatment is for people with colon cancer that has spread to the abdominal lining (peritoneum). Cancer that has spread here is called peritoneal carcinomatosis, or peritoneal cancer.

Treating liver metastases

Over the past decade, amazing advances have been made in treating colon cancers that have spread to the liver. If you have liver metastases, surgeons and interventional radiologists work together at UW Medicine’s Secondary Liver Tumor Clinic to determine which treatment approaches will work best for you. Treatments may include concurrent liver and colon surgeries, external-beam radiation therapy or catheter-based therapies, such as transarterial chemoembolization.

Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Chemoembolization A procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor.

A procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor. The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells. It also causes fewer side effects because very little of the drug reaches other parts of the body. Chemoembolization is used to treat liver cancer. Also called TACE and transarterial chemoembolization.

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