Colon Cancer Treatment: A Complete Guide
Updated on August 18, 2026
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Treatment options for colon and rectal cancer include surgery, radiation, and medication approaches such as chemotherapy and targeted therapy.
To choose what’s best for you, you and your doctor will consider where the tumor is located, how large it is, and whether the cancer has spread (metastasized). You’ll also weigh personal factors like your overall health and how well you can handle possible side effects.
Perspectives
Ian
Cancer survivor
“So it was a big surgery, and that took some coordination between the doctors. And I had to personally kind of push them to get on the same schedule to get it done.”
Transcript Available
Colonoscopy and Surgery
If colorectal cancer is considered localized, doctors can remove tumors or precancerous growths with one of several types of procedures.
Local Excision or Polypectomy
Surgical resection is the mainstay of curative treatment for small, early-stage colon and rectal tumors. Precancerous growths called polyps can often be removed during a colonoscopy. The doctor threads a colonoscope — a long, thin, flexible tube with a tiny video camera at the end — through the anus. Tools are inserted through the colonoscope to remove the polyp.
Colectomy or Proctectomy
For a tumor that is large or has grown deeper into your tissue, the surgeon may remove a portion of your colon or rectum, along with a small margin of healthy tissue and nearby lymph nodes.
The healthy ends of the colon or rectum are then reattached if possible.
A colectomy or proctectomy can be performed through an open technique, meaning the surgeon cuts through your abdomen. But it’s often possible to use a less invasive technique called laparoscopy, in which the surgeon makes several small incisions — one for a laparoscope (a camera similar to a colonoscope) and others for long, thin surgical instruments.
If the surgeon can’t reattach the ends of the colon immediately, they will make an opening in the abdomen called a stoma for waste to pass out of the body and into an airtight ostomy pouch. This is usually temporary, while your digestive tract heals, but for some people it’s permanent.
Ablation
When colon cancer has spread to spots in your lungs or liver, a surgeon may use extreme heat or cold to kill cancer cells or block blood flow to them. Techniques include cryosurgery (freezing with a metal probe) or radiofrequency ablation (burning with high-energy radio waves.)
Surgery Risks
As with all surgeries, colon cancer surgery has risks, including:
- Bleeding
- Blood clots
- Infection
- Injury to nearby organs
- Scar tissue formation
A specific risk after colon surgery is an ileus, which is a type of paralyzed bowel. Your colon doesn’t work correctly and can’t move waste. It’s usually a temporary side effect of surgery. Your doctor may have you avoid eating or drinking until normal function resumes.
Another possible risk is anastomosis, a leak at the point where the healthy ends of the intestine were connected.
Radiation Therapy
Radiation therapy is a routine, central part of treatment for rectal cancer, but it plays only a small, occasional role in colon cancer, which is usually treated with surgery and chemotherapy instead.
Radiation therapy relies on high-energy X-rays or other types of radiation to destroy cancer cells.
It may be combined with chemotherapy before surgery to shrink a tumor and make it easier to remove. You might also have it during or after surgery to kill any cancer cells that might have been left behind.
Radiation combined with chemotherapy may also be an option for people who can’t have surgery, or to treat colon cancer that has spread to other parts of your body.
Two main radiation techniques are used in colon cancer treatment:
- External-beam radiation therapy: A machine outside your body focuses radiation at the tumor.
- Internal radiation therapy: Radioactive material is placed inside your body, either next to or inside the tumor.
With either type, you’re exposed to radiation for a few minutes at a time over several sessions.
Radiation Therapy Risks
While radiation therapy for colon or rectal cancer is focused on the tumor, it can also damage nearby healthy tissue. That can cause some uncomfortable side effects, including:
- Fatigue
- Skin irritation
- Diarrhea
- Sexual dysfunction
- Nausea and vomiting
- Bladder inflammation
Poll
How do you best manage stress during colorectal cancer treatment?
Chemotherapy
Chemotherapy is a systemic treatment that delivers cancer-fighting medicine throughout your body. It’s mainly used to slow the growth of colon cancer that has metastasized. But it may also be given before surgery to reduce the size of a tumor, or after surgery to kill any cancer cells left behind.
Chemotherapy drugs may be given orally or intravenously (IV). You get treatment in cycles of several weeks with break periods in between. It may go on for several months.
The medicines commonly used for colorectal cancer are:
- capecitabine (Xeloda)
- fluorouracil (5-FU)
- irinotecan (Camptosar)
- oxaliplatin (Eloxatin)
- trifluridine and tipiracil (Lonsurf)
These drugs are frequently used in combination with each other and with other kinds of medications.
For colon cancer that has spread to the liver, chemotherapy can be inserted directly into the artery that leads to the liver. This may reduce the amount of treatment side effects.
Possible Chemotherapy Side Effects
Chemotherapy affects your whole body. These medications are designed to kill fast-growing cells. That includes cancer cells, but also many kinds of healthy cells. Some side effects you may experience include:
- Hair loss
- Mouth sores
- Fatigue
- Diarrhea
- Loss of appetite
- Skin irritation
- Nerve damage
Treatment
Description
Surgery
Small tumors or precancerous growths can be removed with minimally invasive procedures. With larger or invasive tumors, sections of the colon or rectum may be removed.
Radiation
High-energy radiation beams are aimed at the tumor to kill cancer cells or shrink a tumor before surgery.
Chemotherapy
Medicines given through an IV or as pills kill cancer cells that have spread to other parts of the body.
Targeted Therapy
Medicines target specific vulnerabilities in cancer cells to slow their growth.
Immunotherapy
Medicines help your immune system identify and attack cancer cells.
Targeted Therapy
Targeted therapy is a newer type of medicine-based treatment used for metastatic colon cancer that can’t be treated with surgery or radiation. It’s often used in combination with chemotherapy.
As researchers have made progress understanding the biochemistry of colorectal cancer, that’s led to the development of drugs that target weaknesses in cancer cells. Tumors are tested for the presence of certain proteins, gene mutations, and other characteristics called biomarkers that indicate how well these treatments may work.
Targeted therapy medications are delivered through an IV or taken orally as pills.
VEGF Inhibitors
These drugs home in on a protein in cancer cells called vascular endothelial growth factor (VEGF). VEGF helps tumors form new blood vessels. Blocking this protein prevents the cancer cells from growing. VEGF inhibitors used to treat colon cancer include:
- bevacizumab (Avastin)
- fruquintinib (Fruzaqla)
- ramucirumab (Cyramza)
- ziv-aflibercept (Zaltrap)
EGFR Inhibitors
These drugs block the protein EGFR (epidermal growth factor), which helps cancer cells grow. They include:
- cetuximab (Erbitux)
- panitumumab (Vectibix)
Gene Mutation Inhibitors
Some colon cancer cells have mutations in the genes that control certain proteins called kinases, which carry signals to the cell’s control center. The defective proteins allow the cancer to grow out of control. If tests show the presence of one of these mutations, you might be prescribed:
- BRAF inhibitor: encorafenib (Braftovi)
- NTRK inhibitors: entrectinib (Rozlytrek), larotrectinib (Vitrakvi), repotrectinib (Augtyro)
- RET inhibitor: selpercatinib (Retevmo)
- KRAS inhibitors: adagrasib (Krazati), sotorasib (Lumakras)
HER2-Targeted Drugs
HER2 is another protein that encourages cancer cells to grow. Drugs that block its action may be helpful if your tumor cells have too much of this protein. They include:
- fam-trastuzumab deruxtecan (Enhertu, T-DXd)
- lapatinib (Tykerb)
- pertuzumab (Perjeta)
- trastuzumab (Herceptin, other names)
- tucatinib (Tukysa)
Multikinase Inhibitor
One targeted therapy medication, regorafenib (Stivarga), is designed to target multiple growth-signaling pathways in cancer cells. It can be used when other treatments haven’t worked, and the tumor cells don’t need to have any particular biomarkers for it to help.
Possible Targeted Therapy Side Effects
Like chemotherapy, targeted therapy drugs work throughout your body. But because they focus more narrowly on characteristics of cancer cells, they may cause fewer or different side effects.
Different targeted therapy drugs cause different side effects, but you may experience:
- High blood pressure
- Abnormal bleeding
- Headaches
- Skin changes
- Fatigue
- Diarrhea
- Liver problems
Immunotherapy
Immunotherapy harnesses the power of the body’s own immune system to attack cancer cells. These drugs target either the PD-1 or CTLA-4 proteins on the immune system’s T-cells that normally prevent them from attacking other cells in the body. By blocking these proteins, they encourage your immune system to fight the cancer.
Immunotherapy for colorectal cancer is delivered by IV infusion. The drugs used include:
- dostarlimab (Jemperli)
- ipilimumab (Yervoy)
- nivolumab (Opdivo)
- pembrolizumab (Keytruda)
Researchers continue to explore other immunotherapy treatments, such as vaccines and CAR T-cell therapy in pursuit of new ways to beat colorectal cancer.
Possible Immunotherapy Side Effects
Immunotherapy can cause serious and even life-threatening reactions.
An infusion reaction can happen while you’re receiving treatment. It’s similar to an allergic reaction and can cause itching, flushing, trouble breathing, fever, and chills.
Immunotherapy drugs may also cause your immune system to attack healthy parts of your body.
More common side effects include:
- Fatigue
- Digestive problems
- Fluid retention
- Joint pain
Palliative Care
Palliative care is designed to make you more comfortable while you’re receiving colorectal cancer treatment. It can help you manage treatment side effects and cancer symptoms like pain, plus address the mental health aspects of living with cancer.
Palliative care is commonly confused with hospice care. Both types of care focus on quality of life and symptom management, but palliative care can be started at any time — even from the moment you are diagnosed — and can be given at the same time as your cancer treatment.
Lifestyle Changes
Lifestyle changes will not treat colon cancer, but they may help prevent the cancer from coming back. For example, a landmark clinical trial found that participating in a structured exercise program following surgery and chemotherapy for colon cancer helped people live longer without the cancer progressing.
It may also help to:
- Maintain a healthy weight.
- Eat plenty of fruits, vegetables, whole grains, and lean proteins, and limit red meat, processed food, and added sugar.
- Avoid alcohol.
- Stop smoking.
Even with successful treatment and healthy lifestyle changes, colorectal cancer can come back. You’ll have follow-up exams and testing scheduled for at least five years to watch for signs of recurrence. This includes colonoscopies, blood tests, and imaging.
Resources We Trust
- Mayo Clinic: Colon Cancer: Diagnosis and Treatment
- American Cancer Society: Treating Colorectal Cancer
- National Cancer Institute: Colon Cancer Treatment
- National Comprehensive Cancer Institute: NCCN Guidelines for Patients: Colon Cancer
- Colorectal Cancer Alliance: Treatment
Additional reporting by Stephanie Langmaid.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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