Treatment options for bowel cancer

Having all the information about recommended treatment choices will help you make a well informed decision about the best treatment pathway for you.

There are a number of treatments available for both early stage and metastatic (advanced) bowel cancer

Bowel cancer and rectal cancer are treated differently, and treatment for metastatic bowel cancer (where the cancer has spread beyond the bowel to other parts of the body) is different to treatment for early stage bowel cancer (where the cancer is isolated to the bowel or the areas immediately surrounding the tumour).

Your medical team will recommend treatment that will give you the best possible outcome for the type and stage of cancer you have. Two types of treatment may be offered for both bowel and rectal cancer:

  • Medical treatment
  • Surgical treatment
Dr explaining treatment options for bowel cancer

Treatments for early stage bowel cancer

  • Surgery is the main treatment for early and locally advanced bowel cancer and the aim is to remove as much of the cancer as possible and the nearby lymph nodes. Part, or all, of the bowel is removed (a colectomy). During surgery, it is sometimes necessary to create a hole in your abdomen called a stoma. This may be permanent or temporary (reversible), depending on an individual’s circumstances. Waste (faeces) that would normally pass through the rectum and anus (back passage) now exits through the stoma into a collection bag or pouch worn on the outside of the body over the stoma.  
  • There are different types of stoma and the type depends on the location of the tumour and the surgery needed. An ileostomy is a surgical procedure that brings the last part of the small bowel (ileum) through the abdominal wall, and the colostomy procedure brings through part of the large bowel. Both procedures allow bodily waste (faeces/stool) to pass through the stoma.
  • If the cancer has spread to the lymph nodes, you may have chemotherapy after surgery. Your specialist will determine if this treatment will be of benefit to you. These treatments do have side effects and some can be difficult to manage. The type and severity of these side effects can depend on the treatment chosen by you and your oncologist.
  • Chemotherapy treatment involves the administration of drugs that either kill cancer cells or prevent them from dividing. When given by mouth, or by injection or infusion into muscle or the bloodstream, it is termed systemic chemotherapy. When placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. This is known as regional chemotherapy. Read more on Chemotherapy and targeted therapies
  • There are a number of medicines used in New Zealand for the treatment of bowel cancer. Some are funded (no cost to the patient) and others are available through co-share payment plans with pharmaceutical companies. These plans assist with the purchase of the drugs but the patient is still responsible for the cost of administration in a clinic or hospital. Medicines used in New Zealand in the treatment of bowel cancer (both early stage and metastatic) can be found here.
  • Radiation therapy is not used for early colon cancer.


Treatments for early stage rectal cancer

  • Surgery is the main treatment for early rectal cancer.
  • If the cancer has spread beyond the rectal wall and/or into nearby lymph nodes (locally advanced cancer), before the surgery you will have either radiation therapy or chemotherapy combined with radiation therapy. After the surgery, you may have chemotherapy. Read more on Chemotherapy and targeted therapies