Treatment

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 SCCA 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.

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.

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 SCCA 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 SCCA.

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)