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Treatment for colorectal cancer

Most colorectal cancer is treated with a combination of one or more of the following treatments:


Every treatment has potential risks and side effects. Before any new treatment or surgery, make sure your healthcare team tells you about what to expect. 

Surgery for colorectal cancer

Surgery for early colorectal cancer may include the following:

  • Polypectomy (polyp removal) is used to completely remove small cancers contained within a polyp during a colonoscopy.
  • Endoscopic mucosal resection (removing and surrounding tissue) allows doctors to remove larger  and a small amount of lining of the colon during a colonoscopy.
  • Minimally invasive or laparoscopic surgery is used to remove that cannot be removed during a colonoscopy. During laparoscopic surgery, small incisions are made in the abdominal wall so that the surgeone can insert cameras to help see the colon and instruments to help remove the cancer.  are removed as well as a part the part of the colon that contains the polyp, and nearby through these incisions.

Surgery for more advanced colon cancer may include the following:

  • Partial colectomy removes the part of the colon that contains the cancer and normal tissue on either side of the cancer. A partial colectomy can often be done using a laparoscope, but sometimes open abdominal surgery is required.
    • Often, after removing the cancer, the surgeon can reconnect the healthy portions of the colon.
    • When it is not possible to reconnect the healthy portions of the colon, the surgeon creates a hole in the wall of the abdomen called an ostomy. Ostomies allow stool to be removed from the body into a bag that fits securely over the opening.
    • Sometimes the ostomy is only temporary, and after time the ostomy can be reversed.  However, in some cases it may be permanent.

Surgery for very advanced cancer may include:

  • If the cancer has spread only to the liver or lung, doctors may recommend surgery in combination with other treatments such as chemotherapy.
  • For people with very advanced cancer or overall poor health, surgery may be used only to relieve a blockage of the colon or to improve symptoms such as bleeding or pain.

For people who have an linked to very high risk for colorectal cancer, more extensive colectomy surgery may be recommended to treat their cancer and prevent new cancers from developing. These surgeries include: 

  • Total proctocolectomy with Ileal Pouch and Anal Anastomosis (TPC IPAA) involves removal of the colon and rectum but spares the anal sphincter. People who have this surgery may remain continent and are able to control bowel movements. The surgeon uses a portion of the small intestine to create an internal pouch, which stores waste until a bowel movement. 
  • Total abdominal colectomy with ileorectal anastomosis (TAC IRA) involves removal of the entire colon but spares the rectum. Not all people are candidates for this surgery, which leaves the risk for rectal cancers. 
  • Total proctocolectomy with permanent end ileostomy (TPC EI) removes the entire colon, rectum  and anus and creates an ostomy opening at the end of the small intestine. 


Chemotherapy for colon cancer is usually given after surgery if the cancer is has spread to deeper layers of the colon wall or has spread to the . chemotherapy may also be used before surgery to shrink a large cancer so that it is easier to remove with surgery.

Chemotherapy for colon cancer is usually a combination of two or three chemotherapy drugs.  The most common chemotherapies are:

  • 5-FU: 5-flourouracil
  • Capecitabine, also known as Xeloda, an oral form of 5-fluoruracil
  • Irinotecan (Camptosar)
  • Oxaliplatin (Eloxatin)

Radiation therapy

Radiation therapy is not often used to treat colon cancer. However, it may be used in some clinical trials.

Treatment side effects

Your healthcare team should explain what you should expect from all treatments, including:

  • all of the possible risks and side effects of each treatment.
  • which side effects may be serious and how to tell. 
  • when and who you should call if you experience a side effect.
  • what can be done to treat or alleviate each side effect. 

Make sure you let your healthcare team know if you experience any side effects of your treatment. For more information about possible treatment side effects, see our section on Cancer Treatment by Treatment Type

Paying For Care
Paying For Care

The majority of public and private health insurance plans are required to cover cancer diagnosis and treatment; copays, coinsurance and deductibles often apply. Patient costs and coverage for specific doctors, facilities or treatments may vary based on your health plan. Visit our section on Insurance and Paying for Care: Treatment  for more information, links to sample appeal letters and other resources. 

Some pharmaceutical companies have assistance programs that help cover the cost for their medications: 

Organizations that offer co-pay assistance:

Other resources:

  • The American Cancer Society provides information and resources on covering the cost of cancer care. Public assistance, such as Medicaid may be available if you are ineligible for other programs. 
  • Needy Meds: Assistance programs to help patients with cost of medications and other healthcare.
  • Triage Cancer offers tools and resources to help individuals cope with the financial aspects of a cancer diagnosis.
Last updated November 12, 2023