Colon Cancer medications & treatments
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Colon cancer, which is also known as colorectal cancer, is the most common type of gastrointestinal cancer. It is the third most common type of cancer in the U.S. and is the second leading cause of death among all cancers. It is estimated that about 1 in 23 men and 1 in 25 women will develop colorectal cancer during their lifetime. It is more common in developed countries and among people of a lower socioeconomic status.
What is colon cancer?
Colon cancer affects the 5-foot to 6-foot-long tube (large intestine) that moves waste products down to your rectum. It most commonly affects adults over the age of 50. Colon cancer is typically grouped with rectal cancer and is known as colorectal cancer.
Colon cancer typically starts as a small, precancerous clump of cells (polyps) on the lining of the colon. They usually grow slowly without symptoms, so early detection and removal are important to stop them before they become cancerous tumors.
Colon cancer causes
Experts are not sure what the exact cause of colon cancer is. Risk factors that increase your chance of developing this condition include:
- Age. If you are over the age of 50, you are more likely to develop colon cancer.
- Personal or family history of colon cancer. You are at a higher risk if you have had colon cancer or polyps before. You are also at an increased risk if you have a first-degree relative with this condition.
- Hereditary conditions. Certain conditions passed through generations of your family can increase your risk, including familial adenomatous polyposis (FAP) and Lynch syndrome, which is also called hereditary nonpolyposis colorectal cancer (HNPCC).
- Race. African-Americans are at a higher risk of colon cancer than other races.
- Inflammatory bowel diseases. Chronic inflammatory conditions of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk.
- Lifestyle factors. Unhealthy behaviors such as smoking, excessive alcohol use, lack of physical activity, eating red meat, and obesity all increase your risk of colon cancer.
- Diabetes. Diabetes and insulin resistance can increase your risk of colon cancer.
- Radiation therapy. If you have had radiation aimed at your stomach to treat other cancers, you are at a greater risk of colon cancer.
How is colon cancer diagnosed?
To properly diagnose colon cancer, your doctor or healthcare professional will look at your symptoms, review your medical history, perform a physical exam, and run some tests.
Colon cancer symptoms
While the early stages of colon cancer typically have no symptoms, as it progresses, you may experience some of the following:
- A change in the consistency of your stool, diarrhea, or constipation
- Rectal bleeding or blood in your stool
- Abdominal pain, gas, or bloating
- Unexplained weight loss
- Feeling that your bowels don’t completely empty
Cancer screening and early detection are keys to increasing your rate of survival. Tests your doctor may use to screen and diagnose you include:
- Fecal occult blood test. This screening test checks for blood hidden in your stool, which can be a sign of colon cancer.
- Barium enema. This procedure uses an enema to fill the colon with a liquid suspension called barium sulfate (barium) so the colon and rectum can be viewed on x-ray. This is not a very accurate method to detect tumors, inflammation, and polyps.
- Flexible sigmoidoscopy. Flexible sigmoidoscopy uses a sigmoidoscope to examine the inside of your rectum and lower colon. Your bowel must be empty for this procedure which is usually done with a laxative and/or an enema prior to the test. If polyps are found, they can be removed and tested for cancer.
- Colonoscopy. This is the most commonly used test to diagnose colon cancer. It uses a thin, flexible tube attached to a camera to examine your entire colon and rectum. Any polyps or tissue samples (biopsy) from abnormal areas can be removed and tested for cancer.
If your doctor determines you have a cancerous polyp, they may perform additional imaging tests such as a CT scan to determine the stage of cancer. Staging represents how far your cancer has spread and will help guide your treatment plan.
The stages of colon cancer are:
- Stage 0 – Precancerous lesions are within the lining of the colon or rectum.
- Stage I – Cancer has grown into the inner layers of the colon
- Stage II – Cancer has spread through the wall of the colon
- Stage III – Cancer has spread to nearby lymph nodes.
- Stage IV – Cancer has spread to organs and other parts of the body (metastasis).
What are some colon cancer treatment options?
Your treatment will depend on several factors, including the stage of the cancer. Your doctor will typically use a combination of surgery, chemotherapy, radiation therapy, and targeted therapy.
If caught early enough, surgical resection may be the only treatment you need. Depending on the stage, your doctor may perform one of the following:
- Polypectomy. This procedure can be done during a colonoscopy to remove any small polyps or lesions.
- Laparoscopic surgery. A surgeon will make several small incisions in your abdominal wall to remove polyps that could not be removed during a colonoscopy.
- Colectomy. This procedure uses several small incisions in your abdominal wall to remove the tumor and all or part of the colon. They will also use this laparoscopic surgery to remove some nearby lymph nodes. Your surgeon can usually reconnect the remaining healthy sections of your colon.
- Colostomy. If your colon can not be reconnected, your surgeon will make an opening in your abdomen (stoma), and connect the remaining colon to it. Stool will pass through the opening and into an attached bag.
Medications are typically used after surgery to kill any remaining cancer cells. They are also used for late-stage cancers or where surgery is not an option. Some options include:
- Chemotherapy. Neoadjuvant chemotherapy is used before surgery to shrink tumors to make them easier to remove. Adjuvant chemotherapy is also given after surgery to kill any cancer cells that remain in the body. Some chemotherapy drugs used to treat colon cancer include Xeloda (capecitabine), Eloxatin (oxaliplatin), and Adrucil (5-fluorouracil).
- Radiation therapy. Radiation therapy uses high-energy x-rays or other particles to destroy cancer cells or slow their growth. This procedure is usually performed by a radiation oncologist. It is often used as a primary treatment if surgery is not an option or you cannot take chemotherapy.
- Immunotherapy. Immunotherapy helps your immune system recognize and attack cancer cells. It is typically used in advanced-stage colon cancer. Some systemic options include immune checkpoint inhibitors such as Keytruda (pembrolizumab) and Opdivo (nivolumab).
- Targeted therapy. Medications such as Braftovi (encorafenib) and Stivarga (regorafenib) target proteins, genes, and other factors specific to your cancer to stop its growth. Your doctor may run tests to identify these specific factors to help determine the most effective treatment. Targeted therapy typically causes less damage to healthy tissue than chemotherapy or radiation.
What is the best medication for colon cancer?
The best medication for the treatment of colon cancer will depend on the individual’s specific medical condition, medical history, medications that the individual is already taking that may potentially interact with colon cancer medications, and the individual’s potential response to the treatment. It is advisable to always speak with your healthcare provider about the best treatment plan for you. The table below includes a list of the most prescribed or over-the-counter colon cancer drugs approved by the Food and Drug Administration (FDA).
Best medications for colon cancer
|Drug name||Drug class||Administration route||Standard dosage||Common side effects|
|Adrucil (fluorouracil)||Antimetabolite||Injection||The dose will depend on the surface area and stage of cancer.||Headache, nausea, vomiting, diarrhea, loss of appetite, hair loss|
|Eloxatin (oxaliplatin)||Platinum analog antineoplastic||Injection||The dose will depend on the surface area and stage of cancer.||Nerve pain, anemia, nausea, fatigue, diarrhea, vomiting, stomach pain|
|Xeloda (capecitabine)||Antimetabolite||Oral||The dose will depend on the surface area and stage of cancer.||Diarrhea, nausea, anemia, swelling, fatigue|
|Wellcovorin (leucovorin)||Folic acid analog||Injection||The dose will depend on the surface area and stage of cancer.||Nausea, diarrhea, vomiting, itching|
|Camptosar (irinotecan)||Topoisomerase inhibitor||Injection||The dose will depend on the surface area and stage of cancer.||Anemia, diarrhea, nausea, stomach pain, vomiting, weakness, hair loss|
|Lonsurf (trifluridine/tipiracil)||Pyrimidine analog||Oral||The dose will depend on the surface area and stage of cancer.||Anemia, weakness, fatigue, nausea, decreased appetite|
|Erbitux (cetuximab)||Monoclonal antibody (EGFR inhibitor)||Injection||The dose will depend on the surface area and stage of cancer.||Rash, fatigue, nausea, dry skin, constipation, shortness of breath|
|Avastin (bevacizumab)||Monoclonal antibody (VEGF inhibitor)||Injection||The dose will depend on your body weight and stage of cancer.||Diarrhea, high blood pressure, anemia, fatigue, joint pain, headache|
|Vectibix (panitumumab)||Monoclonal antibody (EGFR inhibitor)||Injection||The dose will depend on your body weight and stage of cancer.||Redness, rash, low magnesium, fatigue, stomach pain, nausea|
|Keytruda (pembrolizumab)||Monoclonal antibody||Injection||200mg via IV infusion every 3 weeks or 400mg every 6 weeks.||High blood sugar, high triglycerides, fatigue, rash, low sodium|
|Zaltrap (ziv-aflibercept)||Tyrosine kinase receptor inhibitor||Injection||The dose will depend on your body weight and stage of cancer.||Diarrhea, elevated liver enzymes, fatigue, protein in the urine, high blood pressure|
|Stivarga (regorafenib)||Tyrosine kinase receptor inhibitor||Oral||4 tablets (160mg) once daily for the first 21 days or each 28-day cycle.||Anemia, weakness, low calcium and phosphate, decreased appetite, diarrhea|
Your healthcare provider will determine the right dosage based on your response to the treatment, medical condition, weight, and age. Other possible side effects may exist; this is not a complete list.
What are the most common side effects of colon cancer medications?
As with all medicines, those used for colon cancer will have some side effects, depending on the class you are taking:
- Chemotherapy drugs can cause you to have low white blood cell counts which increases your risk of infections. Some other common side effects include nausea, vomiting, hair loss, anemia, fatigue, muscle pain, headache, and joint pain.
- Immunotherapy medications can cause joint and muscle pain, fatigue, rash, diarrhea, cough, nausea, vomiting, constipation, and itching.
- Targeted therapy medications can commonly cause fatigue, nausea, joint and muscle pain, diarrhea, headache, high blood sugar, and decreased levels of electrolytes.
What are some home remedies for colon cancer?
There are no home remedies or natural ways to treat or cure colon cancer. A combination of surgery, medications, and radiation are the treatments you will need to treat this condition. After completing treatment, it’s very important to go to all of your follow-up appointments.
Doctors recommend that people with an average risk of colon cancer should be screened around age 45. If you are at an increased risk, such as having a family history of colorectal cancer, you should get screened sooner.
Colon cancer prevention
Some lifestyle changes and self-care measures you can take to reduce your risk of colon cancer include:
- Eat a healthy diet consisting of high-fiber and low-fat foods such as fruits and vegetables.
- Limit or avoid alcohol. If you choose to drink, men should limit it to 2 drinks a day and women 1 drink a day.
- Stop smoking.
- Exercise regularly and maintain a healthy weight.
Frequently asked questions about colon cancer
Can colon cancer be cured?
If caught early, colon cancer can be cured. Talk with your doctor about colorectal cancer screening, especially if you have an increased risk.
What is the life expectancy for colon cancer?
According to the American Cancer Society (ACS), the five-year survival rate for colon cancer is 90% for localized tumors and 14% for metastasized cancer.
What foods can help reduce your risk of colon cancer?
Experts recommend a diet consisting of the following can help lower your risk of colon cancer:
- Fruits such as apples, berries, cantaloupes, mangoes, and pears.
- Vegetables such as broccoli, cabbage, carrots, cauliflower, celery, cucumbers, kale, lettuce, and spinach.
- Fish such as mackerel, salmon, and tuna.
- White meats such as chicken and turkey.
- Beans and legumes such as lentils, black beans, and kidney beans.
- Whole grains such as oats and quinoa.
- Nuts such as almonds, cashews, hazelnuts, pecans, and pistachios.
What are some common symptoms of colon cancer?
The most common symptoms associated with colon cancer include:
- Persistent diarrhea
- Rectal bleeding
- Blood in your stool
- Constant urge to have a bowel movement
- Feeling like you can’t completely empty your bowels
- Stomach cramps or bloating
- Unexplained weight loss
Where can I find clinical trials for colon cancer?
Research is ongoing to find new treatments for colon cancer. The National Cancer Institute has more info and tools to find a clinical trial that may be right for you.
Related resources for colon cancer
- The pathophysiology of colon cancer. StatPearls, National Library of Medicine.
- Colon cancer practice essentials. MedScape
- General information about colon cancer. National Cancer Institute
- Colon cancer overview. John Hopkins Medicine
- Colorectal cancer. American Institute of Cancer Research
- Colon cancer symptoms and causes. MayoClinic