Chemotherapy is commonly used to treat Colorectal Cancer. Chemotherapy is the use of drugs to kill cancer cells.

When is Chemotherapy used for colorectal cancer?

Chemo can be used for Colorectal Cancer at various times during treatment:

Adjuvant Chemotherapy is given after Surgery. The aim is to destroy any cancer cells that may have been left behind during Surgery because they were too small to see, as well as cancer cells that may have dispersed from the main tumor and spread in other areas of the body but are too small to be seen on imaging tests. This helps to reduce the risk of cancer returning. Neoadjuvant chemo (sometimes with radiation) is administered before Surgery to try to shrink the cancer and make removal easier. Often this is based on Rectal Cancer. For advanced cancers that have spread to other organs like the liver, chemo can be used to help shrink tumours and ease problems they are causing. While it is not likely to cure the cancer, this often helps people feel better and live longer.

How is Chemotherapy given?

Chemotherapy can be given in different ways.

Systemic chemotherapy: Drugs are inserted into a vein in your blood or you administer them by mouth. The medications go through the bloodstream, entering all parts of the body. That can help to reduce the risk of spreading Colorectal Cancer to other parts of the body. Regional chemotherapy: Drugs are put right into the artery leading to the part of the tumour in the body. Which focuses the chemo on the area’s cancer cells. It eliminates side effects by constraining the amount of medication that enters the rest of the body. Hepatic artery injection, or chemo delivered directly into the hepatic artery, is an example of often used regional Chemotherapy for cancer that has spread to the liver.

Doctors give chemo in cycles to give the body time to recover, with each treatment followed by a rest period. Chemotherapy cycles generally last approximately two to four weeks. People usually get a minimum of several treatment cycles.

Chemotherapy drugs used to treat colorectal cancer

Some drugs commonly used for Colorectal Cancer include:

• 5-Fluorouracil
• Capecitabine
• Irinotecan
• Oxaliplatin
• Trifluridine and tipiracil, a combination drug in pill form

Side effects of chemotherapy

Chemo drugs target rapidly dividing cells and thus they function against cancer cells. However, other cells in the body, such as those in the bone marrow (where new blood cells are formed), mouth and intestine lining, and hair follicles, are also rapidly dividing. Chemo can affect these cells too, which can result in side effects.

Chemo’s side effects depend on the type and dosage of drugs given, and how long you are taking them.

Common Chemo side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Increased chance of infections (from having too few white blood cells)
• Easy bruising or bleeding (from having too few blood platelets)
• Fatigue (from having too few red blood cells)

Other side effects are specific to certain drugs. Example:

Hand-foot syndrome can develop by capecitabine, when given as an infusion. This can begin in the hands and feet as redness, and then progress to Pain and discomfort in the palms and soles. The skin will blister or peel, if it worsens, often leading to painful sores. It is important to inform your doctor about any early signs right away, so you can take action to prevent things from getting worse.

A common side-effect of oxaliplatin is neuropathy (nerve damage). Symptoms include tingling, numbness and even Pain in the hands and feet. This may also cause extreme heat and cold discomfort in your mouth, esophagus (the tube that connects the mouth to the stomach), and the palms of your hands. When swallowing liquids or holding a cold glass this may cause discomfort. When you are having oxaliplatin, discuss side effects with your doctor beforehand, and let him or her know immediately when you experience numbness and tingling, or other side effects.

Oxaliplatin can cause allergic or adverse reactions in some people, while receiving the drug. Symptoms can include skin rash; tightness of the chest and breathing difficulties; back pain, or feeling dizzy, lightheaded or weak. If you notice any of these symptoms while you are getting chemo, be sure to tell your nurse immediately.

Diarrhea is a common side effect of all of these medications, but with irinotecan it can be especially severe. To avoid serious dehydration, it must be treated promptly — at the first loose stool. This involves taking a drug such as loperamide. If you receive a chemo drug that is likely to cause diarrhea, your doctor will advise about what medications should take, and how long to take them to control this problem.

Most of these side effects tend to fade in the course of time after ending treatment. Others, such as oxaliplatin hand and foot numbness, will last long. Complementary and alternative medicine cane also relieve the side effects.

Be sure to answer any questions with your cancer care team about side effects. Please record any adverse effects or changes that you experience when you get chemo, and they can be treated immediately. In certain cases, the doses of the chemo medications may need to be increased, or therapy may need to be postponed or halted to help prevent the condition going. Some types of chemo for Colorectal Cancer seem to be fairly well tolerated by the older people. Age is no excuse for otherwise safe people to refuse medication.