CHEMOTHERAPY
Chemotherapy simply means drug treatment. These drugs are usually given either in tablet form, injection or infusion into a vein. The type of treatment you receive will depend on a number of factors, such as the type of cancer you have, where it is in the body and to what extent it may have spread. Chemotherapy may also be used as a main treatment or as a backup treatment after surgery. For most patients surgery is the main form of treatment. The aim of the chemotherapy treatment is to get rid of any remaining cancer cells and reduce the chance of the cancer coming back in the future. This is called adjuvant chemotherapy. To help you decide whether adjuvant chemotherapy may be appropriate in your case, your specialist cancer doctor (oncologist) will take into account the risk of any cancer cells being left behind. The likelihood that the chemotherapy will get rid of them and the possible side effects of the treatment. Chemotherapy may also be given when the cancer has spread to another part of the body. The most common parts of the body for the colon and rectal cancer to spread are to the liver and the lungs. Although secondary cancer of the large bowel cannot usually be cured, treatment with chemotherapy may be recommended by your doctor. Often the aim of the chemotherapy is to shrink the tumour and improve symptoms. This can sometimes help to prolong life. Chemotherapy may be given to shrink tumours before they have moved from the liver or more rarely the lungs. Your treatment plan will probably include receiving a combination of different drugs. The timing and duration of treatment varies widely. Before you start any treatment you will be seen in the oncology outpatient area by the consultant oncologist, who will discuss your treatment with you. You will be given information regarding your treatment and also an opportunity to discuss with the doctors and nurses in the oncology centre in detail your chemotherapy prior to it starting. The oncology nurses deal with patients with cancer every day, and you will find that they are extremely helpful and like all of us are happy to answer any questions you may have.

ADJUVANT THERAPY (Chemotherapy that is given after surgery)
• In many people the cancer might never come back, regardless of whether or not they have had adjuvant therapy.
• Adjuvant therapy is not a guarantee that the cancer will never come back.
• Adjuvant therapy is of greater benefit to people with a higher risk of cancer coming back.
• For people with early stage colon or rectal cancer there is no proven benefit for adjuvant therapy.


RADIOTHERAPY
Radiotherapy treats cancer cells by using high energy rays which destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy is used to treat cancer of the rectum. Some people need to have both chemotherapy and radiotherapy given over a period of weeks. If the tumour is large, radiotherapy can be given before surgery to shrink the tumour and make it easier to remove. If a bowel cancer has spread or come back, particularly in the pelvic area (after initial treatment), radiotherapy may be used to shrink the cancer. It can also be used to relieve symptoms such as pain. Before you start your treatment you will be seen by a consultant oncologist who will discuss with you what is involved in having radiotherapy. Radiotherapy normally starts a couple of weeks after you have seen the oncologist. To ensure you receive maximum benefit from your radiotherapy it has to be carefully planned. This involves two further scans. Radiotherapy is not painful, it takes a few minutes, and treatment is usually Monday to Friday as an outpatient. Your oncologist will discuss any potential side effects, also the duration of both treatments, chemotherapy and radiotherapy, but if you have any queries at all please don’t hesitate to ask either the oncologist, the staff in the oncology department or your nurse specialist, they will be more than happy to answer any questions you may have.