Colorectal Cancer Treatments

At UT Southwestern, our colorectal cancer experts create customized treatment programs based on each patient’s unique situation. Once we determine a diagnosis, we collaborate closely with each patient to create a personalized care plan. Depending on the stage and nature of the cancer, we might recommend one or a combination of treatments.

Treatments differ based on the type of colorectal cancer diagnosed.

A Multidisciplinary Approach to Rectal Cancer Treatment

Surgery

Small rectal cancers that have not invaded the muscle of the rectum can sometimes be removed with surgery alone. Large rectal cancers require radiation therapy and/or chemotherapy before surgery to minimize the spread of cancer.

The surgery can be done through an open (conventional) or minimally invasive or laparoscopic technique. Laparoscopic surgery can also be performed using a robot, which has arms that hold the instruments and is controlled by the surgeon. This approach results in less pain, a shorter length of stay in the hospital, and faster recovery than open surgery.

In some patients, the colon must be routed to a temporary or permanent opening on the abdomen called an ostomy.

Radiation therapy

This therapy is recommended for rectal cancer that has penetrated the wall of the rectum or involves surrounding structures or lymph nodes. Radiation is the transmission of high-energy rays that kill cancer cells in the vicinity of the rectum prior to surgery, which improves the chances that cancer will not return in the future.

Chemotherapy

Chemotherapy involves the use of drugs to kill cancer cells, often by stopping their multiplication. In rectal cancer, chemotherapy can be combined with radiation or prescribed alone for three to six months, which decreases the chances that cancer will return to other organs.

Watch and wait

In some rectal cancer patients, the cancer goes into remission after initial radiation and chemotherapy treatments. Such patients can be placed under “active surveillance,” meaning they will have follow-up examinations to look for the return of cancer. This can allow the patients to avoid surgery and preserve the rectum.

Imaging

Images of the rectal cancer are obtained before starting any therapy to determine the spread of the cancer. Imaging is also used to assess the effect that chemotherapy and radiation therapy have on a cancer prior to surgery.

Fertility treatment

Rectal cancer is increasing among young adults, and the treatments for the cancer can affect fertility in men and women. These patients may have a consultation with a fertility specialist to determine the best way to preserve their fertility.

Early-Onset Colorectal Cancer Treatment

Patients with early-onset colorectal cancer encounter unique hardships. Our team provides compassionate and individualized treatment for these patients, including the following:

Multidisciplinary care

Each patient’s case is reviewed at a weekly meeting of surgeons, oncologists, radiation oncologists, radiologists, and pathologists specializing in colorectal cancer.

Genetic counseling

All patients are referred to a genetic counselor who will discuss their family history and possibly propose additional testing to determine whether they have an inherited risk for colorectal cancer. The results of this testing may change the patients’ treatment, follow-up care, and screening for other cancers and could also mean that family members need to be screened.

Support services

Our support services tailored toward young adults include fertility counseling, nutrition guidance, access to social workers, and more.

Patient support groups

Our Young Adult Cancer Support Group, led by young adult cancer survivors and our team of social workers, connects patients through meetings and social events.