Chemotherapy is a term used by doctors to refer to drugs that can kill cancer cells. Chemotherapy drugs can be given in a variety of ways, including intravenously by injection, intravenously with a pump, or even in pill form taken by mouth. Each drug works against a specific cancer, and each drug has specific doses and schedules for taking it. Chemotherapy can be given in a variety of situations:
Palliative chemotherapy is used when colorectal cancer is advanced and has already spread to different parts of the body. In this situation, surgery cannot eliminate the cancer, so your best bet is to be treated with chemotherapy, which may shrink tumors, alleviate symptoms, and prolong life.
Adjuvant chemotherapy is given after the cancer is surgically removed. The surgery may not eliminate all the cancer cells, so the adjuvant chemotherapy treatment is used to kill any that may have been missed, such as cells that may have metastasized or spread to the liver.
Neoadjuvant chemotherapy is chemotherapy given before surgery. Chemotherapy drugs may be given prior to surgery in order to shrink the tumor so that the surgeon can completely remove it with fewer complications. Chemotherapy is also given with radiation, as it makes the radiation more effective.
Talk to your doctor to determine the best treatment strategy for you.
5-Fluorouracil (5-FU) has been the first-choice chemotherapy drug for colorectal cancer for many years. It is used in combination with leucovorin (a vitamin), which makes 5-FU more effective. 5-FU is given intravenously. Recently, a pill form of 5-FU has been developed, called Xeloda, which is used for colorectal cancer that has spread to other organs. Xeloda is also being used as adjuvant therapy or neoadjuvant therapy with radiation in patients with rectal cancers to heighten the effect of radiation. Other drugs include Camptosar and Eloxatin. These drugs are usually combined with 5-FU or Xeloda after surgery or in the advanced setting.
Several new chemotherapy drugs also are used for the treatment of colorectal cancer that has spread. These include Vectibix, Erbitux, Avastin and Aflibercept and are usually given along with 5-FU plus Camptosar or Eloxatin for metastatic colorectal cancer. Regorafenib is another new drug, that can be taken orally as a single agent after the other drugs have stopped working.