Colorectal Cancer Treatment
Treatment at MD Anderson’s Gastrointestinal Center combines the latest technology and research with a multidisciplinary team approach tailored to your unique needs.
Our team of surgeons use minimally invasive techniques, including advanced robotic surgery, that reduce recovery time and maximize quality of life. MD Anderson also offers clinical trials for patients at every disease stage, from newly diagnosed small tumors to patients with stage IV cancer.
Colorectal cancer treatment plans
Colon cancer that has not spread to distant parts of the body is usually treated with surgery. Some patients then receive chemotherapy or, less commonly, radiation therapy to kill any remaining cancer cells.
Rectal cancer that has not spread is usually treated with surgery. These patients may receive chemotherapy or radiation therapy before the procedure. They may also undergo these treatments after surgery to kill any remaining cancer cells.
If colorectal cancer has spread, or metastasized, to distant parts of the body, some patients can still be cured. With new treatments, colorectal cancer that has spread can often be managed like a chronic condition and care is meant to prolong life and preserve quality of life. Treatments for all patients with metastatic colorectal cancer can include surgery, radiation therapy, cryotherapy, microwave ablation, and cancer drugs like chemotherapy, targeted therapy and immunotherapy.
Surgery
Surgery is the most common treatment for colorectal cancer, especially if it has not spread. Surgery for colorectal cancer is most successful when done by a surgeon with a great deal of experience in the procedure. At MD Anderson, these procedures are performed by surgeons who specialize in colorectal cancer surgery and are national and international leaders in the field. Surgeons around the country often refer their patients to MD Anderson surgeons for their expertise, especially for the most difficult cases.
The type of surgery depends on the stage and location of the tumor. Visit the colon cancer treatment page or rectal cancer treatment page to learn about the surgical procedures for each disease.
Chemotherapy
Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing.
Targeted Therapy
Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level. Cancer cells need specific molecules (often in the form of proteins) to survive, multiply and spread. These molecules are usually made by the genes that cause cancer, as well as the cells themselves. Targeted therapies are designed to interfere with, or target, these molecules or the cancer-causing genes that create them.
Radiation therapy
Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.
Radiation therapy is frequently used to treat rectal cancer. For colon cancer, it is used only in very limited situations.
Cryoablation
Cryoablation, also known as cryotherapy or cryosurgery, uses cold to kill tumor cells. During the procedure, a special probe is inserted into the tumor and then cooled to temperatures well below freezing. A ball of ice forms at the tip of the probe, freezing and destroying cancerous tissue. Cryotherapy is not as invasive as surgery and can sometimes be performed as an outpatient procedure.
Microwave ablation
Microwave ablation uses heat to kill cancer cells. During the procedure, a probe delivers microwaves directly to the tumor, heating the tissue until it is destroyed. Microwave ablation is not as invasive as surgery and can sometimes be performed as an outpatient procedure.
Immunotherapy
The immune system finds and defends the body from infection and disease. Cancer is a complex disease that can evade and outsmart the immune system. Immunotherapy improves the immune system’s ability to eliminate cancer.
There are two types of immunotherapy currently used to treat colon cancer:
- Immune checkpoint inhibitors stop the immune system from turning off before cancer is completely eliminated.
- Monoclonal antibodies attach to specific proteins on the surface of cancer cells or immune cells. They either mark the cancer as a target for the immune system or boost the ability of immune cells to fight the cancer.
Angiogenesis inhibitors
Angiogenesis is the process of creating new blood vessels. Some cancerous tumors are very efficient at this process. New blood vessels increase blood supply to a tumor, allowing it to grow rapidly. Angiogenesis inhibitors, or anti-angiogenic therapy, disrupt the creation of these blood vessels.
Clinical trials
Clinical trials are a key component of MD Anderson's mission to end cancer. Patients may volunteer to participate in these research studies, which help doctors improve cancer prevention, diagnosis and treatment.
Some clinical trials allow patients to receive experimental medications or treatments, though not all patients are eligible.
Learn more about colorectal cancer:
Featured Podcast:
Navigating skin side effects of targeted cancer therapy
20-year-old patient: You’re never too young to get colorectal cancer
I was just coming off of my first year playing college basketball in August 2021 when I was diagnosed with stage IV colorectal cancer.
I felt scared and very confused. I’ve always watched my weight and cared about what I put in my body. So, I didn’t understand how I could have colon cancer at the age of only 19.
I learned the reason right after my diagnosis: genetic testing showed I have Lynch syndrome. It’s a hereditary condition that makes me more likely to develop multiple cancers over my lifetime. I am the first person in my family to have it.
Glad to be the only one in my family with Lynch syndrome
Because I tested positive for Lynch syndrome, genetic counselors recommended that the rest of my immediate family get tested, too. I was relieved to learn that no one else had it.
Hopefully, this means that none of them will have to go through what I did: the extreme back and hip pain that eventually led to my diagnosis, the surgery needed to remove the golf-ball-sized tumor embedded in almost eight inches of my colon, and the chemotherapy/immunotherapy combination I’m still receiving that initially gave me such severe diarrhea that I lost 45 pounds in just under three months.
Since I’m the first person in my family to have Lynch syndrome, I’ll also know to look for it in future generations. But I found out while looking into fertility preservation options before treatment that there’s existing technology that can modify the Lynch syndrome gene in sperm before it gets used for egg fertilization. So, theoretically, I could have children someday without passing the Lynch mutation on to them. That’s a huge relief.
How having Lynch syndrome has helped me
If there’s anything good to be said about having Lynch syndrome, it’s probably that it made me eligible to participate in a clinical trial at MD Anderson. My local doctors had a treatment plan laid out after my surgery, but my family and I wanted a second opinion. We knew MD Anderson is the best place in the country for cancer treatment. So, that’s where we went.
We met with medical oncologist Dr. Michael Overman. He said my tumors are considered microsatellite instability-high. This means the cancer cells have a hard time hiding from the immune system. That was great news, because the immunotherapy clinical trial he recommended would strengthen my own immune system to better fight off the cancer.
He also said that some participants were seeing very high success rates, but that the research is still ongoing. That was all I needed to hear. I joined the trial on Oct. 11, 2021.
My colorectal cancer treatment on a clinical trial
I’ve shown no new growth or metastases since the surgery I had on Aug. 13, 2021. But I’m not going to lie: my treatment days are long and hard. I spend one out of every 14 days receiving drugs intravenously at the hospital. Then, I go home with a chemotherapy pump that runs for 46 hours.
But a six-week course of steroids stopped the diarrhea caused by my body’s inflammatory response to the immunotherapy. So, I was able to get back on it again in January 2021 with no side effects.
Making peace with life after a Lynch syndrome diagnosis
At my age, I should still be playing college basketball and hanging out with my friends. Instead, I’ve been getting colorectal cancer treatment for six months and spending a lot of time home alone.
I’m no longer able to play basketball competitively. So, I couldn’t return to Manhattan Christian College in Kansas. But I’m taking a full load of online courses now locally. And I’m able to enjoy my social life again with no restrictions.
I’ve made peace with the fact that I’ll probably never play college basketball again. It was my dream to do that ever since I was a little kid, but I actually got to do it for a while. That’s enough. Now, I’m continuing to work hard toward my degree in communications. That goal hasn’t changed. I’ll also keep making the most of every day, because each one is a gift, no matter what.
It feels great knowing I’m contributing to cancer research. Doctors are diagnosing more and more people under the age of 50 with colorectal cancer each year, but my age still makes me a very unusual case. That’s why I get a sense of security in knowing I’ll need close monitoring for the rest of my life. If anything else ever shows up, it will be taken care of quickly.
If there’s one thing people can take away from my experience, it’s that you’re never too young to get colorectal cancer. So, if you feel like something’s wrong, talk to your doctor. And take any and all symptoms seriously. It might just save your life.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
Young adult colon cancer survivor says support was vital during treatment
At age 26, Savannah Kaspar was a typical young adult: working, spending time with family and friends and planning trips. But after a colorectal cancer diagnosis, she faced a lot of unknowns.
Savannah’s colorectal cancer symptoms
In February 2023, Savannah started having pain in her lower abdomen. She thought it might be due to an ovarian cyst, so she saw her gynecologist. A routine exam showed there wasn’t any cause for concern, so her doctor had her keep a food diary to see if anything she ate made the pain worse. Her diet didn’t seem to be causing the issues and the pain continued, so her doctor scheduled an ultrasound.
A few months later, Savannah developed more symptoms.
“I started having really bloody stools, so I went to the emergency room,” she says. “My CT scan was normal, so they referred me to a gastroenterologist who did bloodwork and a stool sample. My stool sample came back positive, but the doctor thought it was due to hemorrhoids. My bloodwork showed a positive inflammatory bowel disease marker, which can be associated with Crohn’s disease.”
Savannah was younger than the recommended age to get her first colonoscopy, but she had abdominal pain, bad constipation and bloody stools. She knew her symptoms were serious, so she pushed for a colonoscopy.
In August, a colonoscopy revealed a mass in Savannah’s sigmoid colon. Doctors said it was noncancerous but told Savannah she needed surgery to have it removed.
“They said it could develop into cancer later,” says Savannah. “They asked if I wanted to go to MD Anderson since I worked there.”
Savannah works as a program coordinator for Nephrology at MD Anderson, so she felt comfortable coming here for her surgery. She had her first appointment a couple of weeks later.
Savannah’s colorectal cancer diagnosis
At MD Anderson, Savannah had bloodwork and another CT scan. The CT scan showed that her lymph nodes were enlarged.
“They suspected I might have stage III colon cancer,” Savannah says. “And the tumor could possibly be attached to my uterus.”
She had a flexible sigmoidoscopy, which examined the rectum and lower part of the colon. Doctors couldn’t reach her tumor during the procedure, so she had a repeat colonoscopy four days later.
A biopsy confirmed Savannah had colon cancer, but the stage was unknown.
“I was shocked,” she says. “I went from thinking I didn’t have cancer to learning it could be stage III. I didn’t know if it was genetic, if I needed a hysterectomy or if I’d need an ileostomy. There were so many unknowns, and they hit me all at once.”
An MRI showed that the cancer hadn’t spread to Savannah’s uterus, so she could have surgery to remove the tumor. But first, Savannah met with oncofertility specialist Laurie McKenzie, M.D., and decided to freeze her eggs. She knew this was important to do before beginning cancer treatment, so she’d have more options for parenthood in the future.
“I went to New York City to have one last trip before I started my colorectal cancer treatment,” says Savannah. “The trip was planned before my diagnosis. It was an awesome opportunity to clear my head and mentally prepare to begin treatment.”
Savannah’s colorectal cancer treatment
On Oct. 18, 2023, Savannah underwent a partial colectomy at MD Anderson to remove part of her colon, including the tumor and a small amount of tissue surrounding it. She had 30 lymph nodes tested, and they all came back clear. The cancer was declared stage II.
The pathology report revealed that Savannah had lymphovascular invasion and perineural invasion. This put her at a higher risk for recurrence. So, eight weeks after surgery, she completed four rounds of chemotherapy to make sure all the cancer was gone. She received infusions of oxaliplatin and took oral chemotherapy capecitabine under the care of gastrointestinal medical oncologist Ryan Huey, M.D., at MD Anderson West Houston, close to her home. Savannah completed her last chemo treatment on Feb. 1.
MD Anderson helps Savannah manage chemotherapy side effects
Like many cancer patients, Savannah says the first round of chemotherapy was the toughest.
“That first night, my left hand locked up and became stiff, and my vision in one eye went black,” recalls Savannah. “I would blink, and in a few seconds my vision would come back.”
Savannah called MD Anderson’s help line and spoke with the on-call oncologist. Because her symptoms were on one side of her body, they had her come to MD Anderson’s Acute Cancer Care Center to make sure she wasn’t having a stroke. Savannah had a CT scan and MRI of her brain. They both came back clear.
Savannah’s hair thinned slightly during treatment, she had muscle cramps at times and she had bad nausea the first week.
“My care team added in an extra nausea medication for my second round of chemo and prescribed a muscle relaxer for my cramps. That helped a lot,” she says. “Dr. Huey and his team had an answer to everything and were so quick to find a solution for my side effects.”
Finding support from family, friends and coworkers
Savannah says her mom, boyfriend and other family and close friends were her biggest supporters during treatment.
“I called my mom almost every day, even before the diagnosis,” she says. “When I was stressed because I knew something was wrong but didn’t know it was cancer, she was always my first phone call. And my boyfriend is my ray of sunshine and positivity. He’s always able to lift my spirits and make me laugh.”
Savannah also had the support of her colleagues at work.
“I’m thankful to my department managers for allowing me to take time off or work from home when needed,” she says. “I’m grateful for the doctors who helped answer my questions. My team collected donations for me and visited me in the hospital. It’s awesome how supportive they were.”
Embracing a new outlook after colon cancer treatment
Savannah continues to have bloodwork done every three months. She will have a CT scan and a colonoscopy a year out from surgery. The results will determine how often she’ll need follow-up testing.
Because she was diagnosed at such a young age, Savannah had genetic testing to make sure she didn’t have Lynch syndrome. This would put her at a higher risk for other cancers. Her genetic testing came back negative.
“When I first reached out to a former colleague after my diagnosis, she said something that really stuck out to me,” recalls Savannah. “She said, ‘Your life is forever changed. Some days will be hard, but it gets better every day.’”
When starting treatment, Savannah wondered if her life had changed forever.
“Looking back, I know it’s true. I’ll never be the same person, but it’s changed me for the better,” she says. “I’m stronger. I don’t stress about little things anymore. I don’t take my health for granted. It’s made me appreciate the positives in life, and it’s made my faith stronger.”
Savannah and her boyfriend are planning a trip to Europe later this year to celebrate the end of her treatment.
She offers this advice for other young people facing a new cancer diagnosis: “Just be open with your care team. They’re always on your side and willing to help.”
Request an appointment at MD Anderson online or call 1-877-632-6789.