Reviewed: 20 Sept. 2005

The primary curative treatment for most colorectal cancer is surgical. The earlier the stage of the disease, the better the prognosis. Undesirable delay in diagnosis is still not uncommon. We recommend the more frequent use of colonoscopy when symptoms persist despite negative barium X-ray examinations. Most of the operations for colon cancer are standard surgical procedures in general hospitals.

Adjuvant chemotherapy is recommended for Stage III and some high risk stage II colon cancer. Patients eligible for adjuvant treatment should be referred as early as possible. Trials showing benefit of adjuvant chemotherapy have generally mandated commencement of chemotherapy within 10-12 weeks of surgery. Commencement within 6 to 8 weeks is optimal.

Radiotherapy has a limited, but useful role in the palliative treatment of colon cancer. (Radiotherapy has a larger role in rectal cancer).

Surgical palliation by means of resection, bypass or colostomy may be of value in selected individuals.

Chemotherapy of advanced colon cancer may provide clinical benefit to selected patients; it is best done under the supervision of a physician skilled in the overall management of advanced colorectal cancer.