Treatment options for colon cancer
Bowel cancer can start in the large bowel (colon cancer) or the back passage (rectal cancer). Your treatment depends on whether you have colon or rectal cancer, as well as the stage of your cancer.
This page is about how your doctor decides which treatment you need for colon cancer that hasn’t spread to another part of your body.
A team of healthcare professionals discuss your treatment options.
The main treatments for colon cancer that has not spread are:
- surgery
- chemotherapy
We have information about rectal cancer, this is different to colon cancer.
When colon and rectal cancer spread to another part of the body it is called metastatic or advanced bowel cancer.
Deciding what treatment you need
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). The team might include a:
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bowel (colorectal) surgeon
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medical cancer specialist or oncologist
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bowel cancer nurse or clinical nurse specialist (CNS)
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bowel cancer research nurse
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stoma nurse
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doctor who specialises in looking at scans (radiologist)
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doctor who specialises in looking at cells under a microscope (pathologist)
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MDT coordinator
Your doctor will talk to you about the treatment they suggest. They will explain its benefits and the possible side effects.
Your treatment will depend on:
- where your cancer is
- how big it is and whether it has spread (the stage)
- the type of cancer
- how abnormal the cells look under a microscope (the grade)
- your general health and level of fitness
Surgery
Most people have 
for colon cancer that hasn’t spread. The type of surgery you have for cancer of the large bowel (colon) depends on the position and the size of the cancer in your bowel.
Your surgeon might be able to take out all of your cancer. For some people this might cure the cancer.
Chemotherapy
uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream.
Your doctor might suggest that you have chemotherapy before, or after, surgery.
Chemotherapy before surgery
Chemotherapy before surgery can shrink the cancer to make it easier for to remove. This is called neoadjuvant chemotherapy.
Chemotherapy after surgery
Your doctor might suggest you have chemotherapy to lower the chance of your cancer coming back after surgery. Chemotherapy aims to kill any cells left behind after your operation. This is called adjuvant chemotherapy.
Treatment by stage
The stage of your cancer means how big it is and whether it has spread.
Stage 1 colon cancer
Surgery is the main treatment.
People with very early colon cancer (stage 1) do not need chemotherapy after surgery.
Stage 2 colon cancer
You have surgery to remove your cancer.
You might have chemotherapy before or after surgery.
Before surgery
You might have chemotherapy before surgery. This is if the MDT team think that it will improve the chance of your surgeon being able to remove all the cancer.
After surgery
Your doctor might suggest chemotherapy after surgery if you are at higher risk of cancer coming back. This depends on the results of your surgery. Chemotherapy can lower the chance of your cancer coming back after surgery.
Stage 3 colon cancer
You have surgery to remove your cancer.
You might have chemotherapy before or after surgery.
Before surgery
You might have chemotherapy before surgery. This is if the MDT team think that it will improve the chance of your surgeon being able to remove all the cancer.
After surgery
Your doctor might suggest chemotherapy after surgery if you are at higher risk of cancer coming back. This depends on the results of your surgery. Chemotherapy can lower the chance of your cancer coming back after surgery.
Stage 4 colon cancer
Your doctor might recommend:
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surgery
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chemotherapy
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immunotherapy
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targeted cancer drugs
Having treatment as part of a clinical trial
Doctors are always trying to improve treatments and reduce side effects. Your doctor might ask you to participate in a clinical trial as part of your treatment. This might be to investigate a new test, a new cancer treatment or to look at different combinations of existing treatments.
Your doctor will tell you if there are any trials that you can enter.
Targeted cancer drugs
Clinical trials are researching using targeted cancer drugs called monoclonal antibodies to treat bowel cancer that has not spread.
Monoclonal antibodies recognise and attach to specific proteins produced by cells. Each monoclonal antibody recognises one particular protein. They work in different ways depending on the protein they are targeting. So, some monoclonal antibodies might block particular proteins that encourage a cancer to grow and others might stop cancer cells from making their own blood supply.
Jan's story
Jan had surgery to remove bowel cancer in 2021.
"The operation went very well. It was keyhole surgery. I was only in hospital for four days."
