Treatments

Colon and Rectal Cancer Treatments

Your cancer care team will tailor your colorectal cancer treatment plan to your unique needs, and it will include a multidisciplinary approach with you at the center of the team.

Your Colorectal Cancer Treatment Team

Northwestern Medicine provides access to leading-edge cancer treatments coupled with compassionate care. Your cancer treatment team may include:

• Surgical oncologists
• Medical oncologists
• Radiation oncologists
• Gastroenterologists
• Palliative medicine physicians
• Pathologists
• Nutritionists
• Social workers
• Interventional radiologists
• Advanced practice nurses
• Geneticists
• Rehabilitation therapists

Cancer Care Closer to Home

Addressing cancer is a multistep journey that may require many visits. During treatment, you need to focus your energy on getting healthy, not getting to the next appointment. That’s why treatment and support services at Northwestern Medicine are conveniently located throughout Chicago and the surrounding suburbs, so you can get quick access to all the expertise and support you need, close to home.

Treatment for colon and rectal cancer may include a single treatment or a combination of surgery, chemotherapy, radiation therapy or targeted therapies.

Surgery

The primary treatment for colorectal cancer is often surgical removal (called resection) of the cancerous part and surrounding lymph nodes, along with a length of normal tissue on either side of the cancer.

Northwestern Medicine has specially trained surgical oncologists with expertise in colorectal cancer surgery. Your colorectal surgeon will collaborate with oncology (cancer care) surgeons that specialize in liver or lung resection or ablation (cauterization) when appropriate. Many of these surgeries can be done using a minimally invasive or robotic approaches.

Medical Therapy

Medications are administered either through the veins or by mouth to interfere with cancer cells’ ability to reproduce. Your medical oncologist will determine the best combination of medications for your stage of cancer.

• Chemotherapy: Chemotherapy eliminates cancer cells that are growing. Chemotherapy may be used to control disease that cannot be operated on, get rid of cancer cells after surgery or shrink cancer before a surgery.
• Immunotherapy: Medications that alter your immune system’s response to cancer may be appropriate therapy in some cases of colon and rectal cancer, specifically cancers associated with Lynch syndrome.
• Molecular therapy: Medications that target specific mutations in your cancer may be recommended in addition to chemotherapy. Your tumor will be evaluated for any mutations that can be targeted with molecular therapy.

Radiation Therapy

Your radiation oncologist (a physician specially trained to treat cancer with radiation) will talk to you about the best options for your diagnosis. Radiation therapy is delivered using a radiation beam from a linear accelerator (linac) directed at the tumor with computed tomography (CT) or magnetic resonance imaging (MRI) guidance. The CT or MRI guidance allows the most radiation to be directed at the tumor while minimizing how much radiation your normal, healthy tissues get.

Radiation treatment options include:

• Three-dimensional conformal radiation therapy (3D-CRT): Detailed 3D images are created using CT or MRI scans to direct the radiation beam to the tumor and any surrounding tissue that may be affected by cancer.
• Intensity modulated radiation therapy (IMRT): High-precision radiotherapy delivers different radiation doses to different parts of the tumor.
• Stereotactic radiotherapy (SBRT): This radiation procedure delivers a single high-dose radiation treatment to a cancerouos tumor. This may be appropriate for smaller tumors.
• Proton therapy: For some tumor types Proton therapy can be a more precise treatment that limits the radiation exposure of normal tissues around the targeted tumor. This can be helpful in certain locations in the body and with certain types of cancers.

The Northwestern Medicine Proton Center* is the first and only health system in Illinois — and the ninth in the country — to offer proton therapy.

*Please note that proton beam therapy is generally not needed for the treatment of gastrointestinal (GI) cancers, and therefore used only for rare cases.

Targeted Therapies

• Radioembolization: Interventional radiologists block a tumor's blood supply with radioactive isotopes. This also delivers radiation with more precision and spares healthy tissue from unnecessary radiation. This minimally invasive procedure may be used if your colorectal cancer has spread to the liver.
• Chemoembolization: A specially trained interventional radiologist can provide anti-cancer medications directly into a tumor through the blood supply it depends on. This allows a higher concentration of the medication to have longer contact with the tumor.
• Ablation therapies: Ablation (cauterization) therapies include microwave ablation and radiofrequency ablation. Ablation treatment destroys tumors without removing them. Often, ablation can be done without surgery by inserting a needle or probe into the tumor through the skin.

Palliative Medicine

Side effects from cancer treatment can affect your quality of life and how your body responds to treatment. Northwestern Medicine is home to a diverse team of palliative medicine specialists who work with your cancer care team to help relieve your pain and manage your symptoms. Palliative medicine specialists can help:

• Treat pain and other physical symptoms of cancer, such as fatigue, nausea, trouble sleeping, poor appetite, breathing problems and weight loss.
• Treat any emotional symptoms, such as depression and anxiety.
• Improve your body’s ability to tolerate cancer treatments.
• Help you better understand tests, procedures and options.
• Guide you and those who care for you to helpful resources.

Throughout your care, the palliative medicine team can support you during your cancer journey and feel better, every step of the way.

Clinical Trials

Clinical trials are research studies that help doctors find ways to prevent and treat cancer. Almost every cancer treatment today is the result of a clinical trial. Clinical trials may be available for every stage of colon and rectal cancer at any time in your treatment plan. Your cancer specialist can discuss clinical trials available that may be a good fit for you.

Find clinical trials offered at Robert H. Lurie Comprehensive Cancer Center at Northwestern Medicine and talk with your physician to decide if a clinical trial is right for you.