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Chemotherapy (chemo) is treatment with anti-cancer drugs that may be injected into a vein or taken by mouth. These drugs travel through the bloodstream and reach most parts of the body. Chemo is often used to treat colorectal cancer.
Chemo may be used at different times during treatment for colorectal cancer:
You can get chemotherapy in different ways to treat colorectal cancer.
Chemo drugs for colon or rectal cancer that are given into a vein (IV), can be given either as an injection over a few minutes or as an infusion over a longer period of time. This can be done in a doctor’s office, infusion center, or in a hospital setting.
Often, a slightly larger and sturdier IV is required in the vein system to administer chemo. These are known as central venous catheters (CVCs), central venous access devices (CVADs), or central lines. They are used to put medicines, blood products, nutrients, or fluids right into your blood. They can also be used to take blood for testing.There are many different kinds of CVCs. The most common types are the port and the PICC line.
Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs. Cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it is given for a few days in a row, or once a week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.
Adjuvant or neoadjuvant chemo is often given for a total of 3 to 6 months, depending on the drugs used. The length of treatment for advanced colorectal cancer depends on how well it is working and what side effects you have.
Some drugs commonly used for colorectal cancer include:
Most often, combinations of 2 or 3 of these drugs are used. Sometimes, chemo drugs are given along with a targeted therapy drug.
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in hair follicles and in the lining of the mouth and intestines, are also dividing quickly. These cells can be affected by chemo too, which can lead to side effects.
The side effects of chemo depend on the type and dose of drugs given and how long you take them. Common side effects of chemo can include:
Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:
Other side effects are specific to certain drugs. Ask your cancer care team about the possible side effects of the specific drugs you are getting. For example:
Most of these side effects tend to go away over time after treatment ends. Some, such as hand and foot numbness from oxaliplatin, may last for a long time. There are often ways to lessen these side effects. For example, you can be given drugs to help prevent or reduce nausea and vomiting or you may be told to keep ice chips in your mouth while chemo is being given to lower the chances of getting mouth sores.
Be sure to discuss any questions about side effects with your cancer care team. Also report any side effects or changes you notice while getting chemo so that they can be treated right away. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to help keep the problem from getting worse.
Older people seem to be able to tolerate some types of chemo for colon or rectal cancer fairly well. Age is no reason to withhold treatment in otherwise healthy people.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Lawler M, Johnston B, Van Schaeybroeck S, Salto-Tellez M, Wilson R, Dunlop M, and Johnston PG. Chapter 74 – Colorectal Cancer. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.
Libutti SK, Saltz LB, Willett CG, and Levine RA. Ch 62 - Cancer of the Colon. In: DeVita VT, Hellman S, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott-Williams & Wilkins; 2019.
Libutti SK, Willett CG, Saltz LB, and Levine RA. Ch 63 - Cancer of the Rectum. In: DeVita VT, Hellman S, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott-Williams & Wilkins; 2019.
National Cancer Institute. Physician Data Query (PDQ). Colon Cancer Treatment. 2020. Accessed at https://www.cancer.gov/types/colorectal/patient/colorectal-treatment-pdq on February 12, 2020.
National Cancer Institute. Physician Data Query (PDQ). Rectal Cancer Treatment. 2020. Accessed at https://www.cancer.gov/types/colorectal/patient/colorectal-treatment-pdq on February 12, 2020.
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Colon Cancer. V.1.2020. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf on Jan 23, 2020.
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer. V.1.2020. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf on Feb 10, 2020.
Last Revised: June 29, 2020
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