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 cancer, where there is no evidence that the cancer has grown through the bowel wall into the pelvis or lymph nodes, 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. Where the tumour is large or invading deeper within the bowel wall, chemotherapy may be offered to mop up any cancer cells that may be left in the body, which the surgeon could not see. One large study has shown that having chemotherapy for stage 2 bowel cancer could reduce the risk of the cancer returning by 4%. There is no strong evidence to suggest that this is beneficial for everyone and it should be considered carefully on an individual basis if your tumour has any “high-risk” features. Please ask your oncologist about this.
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 help 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 targeted therapies as appropriate.
Chemotherapy is used at different stages of treatment, and can be used in combination to make other treatments more effective:
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 given directly into a vein. This could be 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.
Intravenous chemotherapy can be given via four different methods:
You can find more information on chemotherapy drugs here.
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 hot and cold food and drink. For advice on ways to manage these side-effects through diet, please download our booklet ‘Living with Bowel Cancer – Eating Well‘.