Chemotherapy is used at several different stages of treatment:
- aimed to shrink the tumour(s) before surgery in order to secure a better outcome following the operation
- to destroy any microscopic cancer cells that may remain after the cancer is removed by surgery and reduce the possibility of the cancer returning
- chemotherapy that has been shown, through extensive clinical trials and research, to be the best option for the type of cancer being treated
- chemotherapy that has been shown, through extensive clinical trials and research to be the best option if the disease has not responded to first-line chemotherapy or has recurred.
- to relieve symptoms and slow the spread of the cancer, if a complete cure is not possible
Unfortunately, as the chemotherapy drugs can also affect some of the healthy cells in your body, they may cause unpleasant side effects. However, damage to the healthy cells is usually temporary and most side effects will disappear once the treatment is over.
The type of chemotherapy treatment you are prescribed depends on many things, but particularly:
- where the cancer started in your body
- what the cancer cells look like under the microscope
- whether the cancer has spread to other parts of your body
A chemotherapy drug can be either given on its own or in combination with other chemotherapy drugs.
Chemotherapy drugs currently available to treat colorectal cancer:
- 5-Fluorouracil (5-FU) and Folinic Acid (Leucovorin) – the standard treatment for advanced colorectal cancer for many years now. 5-FU works by blocking the enzymes in cancerous cells, slowing down or even stopping their growth. 5-FU’s effectiveness is enhanced when folinic acid, a vitamin, is used in combination with it
- Oxaliplatin (Eloxatin) – Used in the treatment of advanced metastatic (having spread to other organs) colorectal cancer in the first line (for the initial treatment of the cancer) and second line (when the first line treatment fails to work) treatment of the disease in combination with 5-FU and folinic acid (known as FOLFOX). Eloxatin can also be used in the adjuvant setting (i.e. after surgery)
- Irinotecan (Campto) - For the treatment of advanced metastatic colorectal cancer in the first line treatment of the disease, in combination with 5-FU and folinic acid (known as FOLFIRI), and as second line monotherapy (on its own) treatment
- Capecitabine (Xeloda) – An oral alternative to intravenous 5-FU/folinic acid. For colorectal cancer patients with Stage III (Dukes C) disease, following surgery, and also as first line treatment for patients with advanced colorectal cancer. Xeloda is administered orally in tablet form twice a day. Once absorbed the tablets are converted to 5-FU
- Tegafur Uracil (UFToral) – Used in the first line treatment of advanced colorectal cancer as an alternative to intravenous 5-FU/folinic acid. UFToral is administered orally in tablet form three times a day. Once absorbed, the body converts them into 5-FU. Tablets are taken for 28 days (usually with folinic acid) followed by a seven-day break.