Treatment of colon cancer

Treatment options of colonic carcinoma consists of

• surgical resection of the lesion.
  • colectomy with en bloc removal of the regional lymph nodes in resectable non metastatic colon cancer (1)
  • resection of metastatic disease and colectomy (same time or separately) in metastatic tumours which are considered resectable (2)
• chaemotherapy
  • adjuvant chaemotherapy after surgery for high-risk stage II and stage III colon cancer (2)
  • preoperative chaemotherapy for resectable metastatic disease (1)
  • palliative chemotherapy in patients with locally advanced or metastatic disease has been shown to reduce death and progression at 12 months (1). The findings translate into a 16% absolute difference in survival and a 25% increase in progression free survival (increases in 3.7 months in median survival and 6 months in median progression free survival) in patients treated with palliative chemotherapy e.g. 5-fluorouracil alone or in combination with other chemotherapeutic agents.
• biological agents (2,3)

The response to radiotherapy is limited by the difficulty of directing the radiation beam at the tumour without damaging surrounding structures, e.g. the bladder.

Reference:

• (1) National Comprehensive Cancer Network (NCCN) 2012. NCCN clinical Practice Guidelines on Oncology. Colon Cancer
• (2) National Institute for Health and Clinical Excellence (NICE) 2014. Colorectal cancer: the diagnosis and management of colorectal cancer
• (3) NICE (January 2020). Colorectal cancer.