Chemotherapy is the use of ‘anti-cancer’ (also known as cytotoxic) drugs to destroy cancer cells in the body. If you have stage 0 or 1 bowel cancer, it should be possible to remove the cancer by surgery and chemotherapy will not be required.

In stage 2 bowel cancers chemotherapy may not be needed. The tissue removed during surgery is examined under the microscope, and the findings discussed at the multi-disciplinary team meeting. If the tumour is large or has spread into the blood or lymph vessels nearby, chemotherapy may be recommended.

If you have stage 3 bowel cancer, surgery to remove the cancer and nearby lymph nodes is usually followed by a course of chemotherapy to prevent the cancer returning.

If you have stage 4 (advanced) cancer, symptoms can be controlled and the spread of the cancer can be slowed using a combination of surgery, chemotherapy, radiotherapy and 

Chemotherapy is used at different stages of treatment, and can be used in combination to make other treatments more effective:

  • Neo-adjuvant – to shrink the tumour(s) before surgery in order to get a better outcome following the operation.
  • Adjuvant – to destroy any microscopic cancer cells that may remain after the cancer is removed by surgery and reduce the possibility of the cancer returning.
  • First-line – chemotherapy that has been shown, through extensive clinical trials and research, to be the best option for the type of cancer being treated.
  • Second-line – 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.
  • Third-line - treatment that is given when both initial treatment (first-line therapy) and subsequent treatment (second-line therapy) don’t work, or stop working.
  • Palliative – to relieve symptoms and slow the spread of the cancer, if a cure is not possible.

How will I receive chemotherapy?

In order for the chemotherapy to destroy cancer cells in the body, the drugs must be absorbed into your blood and carried throughout your body. The chemotherapy drugs can be given in different ways:

  • Oral chemotherapy: If your chemotherapy drug is available as a tablet you can swallow, this can be taken at home. You only go to the hospital for routine outpatients' appointments, which include a blood test. As oral chemotherapies can cause side-effects it is important to keep a diary of how you are feeling and possible side-effects to ensure that you are able to identify and report them to your medical team immediately.
  • Intravenous (IV) injection: The treatment is injected into a vein. There are a wide range of schedules for chemotherapy which can vary from a small injection over a few minutes, a short infusion of up to 30 minutes, or longer infusions over the course of a couple of hours or even a couple of days.

Methods of intravenous chemotherapy

Intravenous chemotherapy can be given via four different methods:

  • Cannula: A small tube inserted into a vein in the back of your hand, or your arm.
  • Central line: A thin, flexible tube inserted though the skin of the chest into a vein near the heart. Hickman® or Groshong® lines are common types and can stay in place for many months.
  • PICC line: A thin, flexible tube passed into a vein in the bend or upper part of your arm and threaded through the vein until the end of the tube lies in a vein near the heart. PICC lines can stay in place for many months.
  • Portacath: A thin, soft plastic tube that is put into a vein. It has an opening (port) just under the skin on your chest or arm.

Please click here for information on the drugs you may be prescribed.

Chemotherapy can affect your sense of taste and smell, dull your appetite and make you feel sick.  It may also make your mouth and throat sore or sensitive to hor and cold food and drink.  For advice on ways to manage these side-effects through diet, please click here or download our booklet 'LIving with Bowel Cancer - Eating Well'.

Last reviewed 15/5/2014

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