Treatment Pathways — Surgery, Chemo, Radiotherapy

Treatment depends on the stage of the cancer and your overall health. Most people are treated within a multidisciplinary team (MDT) that includes surgeons, oncologists, radiologists, and specialist nurses.

Key Pathways

Surgery

• Often the first-line treatment.
• May involve removing part of the bowel (colectomy) with nearby lymph nodes.
• Can be open or laparoscopic (“keyhole”) surgery.
• In some cases, a stoma (colostomy/ileostomy) may be required temporarily or permanently.

Chemotherapy

• Used to reduce recurrence risk after surgery (adjuvant therapy).
• May shrink tumours before surgery (neoadjuvant therapy).
• Also used in advanced disease to slow progression and manage symptoms.
• Common drugs: 5-FU, capecitabine, oxaliplatin.

Radiotherapy

• More common in rectal cancer than colon cancer.
• Often given before surgery to shrink tumours and reduce local recurrence risk.
• May be combined with chemotherapy (chemoradiotherapy).

What to Expect

• Side effects vary depending on treatment: fatigue, nausea, diarrhoea, or neuropathy.
• MDT teams provide supportive care: dietetics, stoma nurses, psychosocial support.
• Regular follow-up with scans and blood tests (including CEA) is standard after treatment.

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Related Guides

• Bowel Cancer Screening
• Living With Bowel Cancer