Patients with early-stage colorectal cancer generally are not required to undergo chemotherapy after surgery. However for patients with late-stage cancers, such as stage II and III, it is likely that cancer cells still remain in the body after surgery therefore chemotherapy is highly recommended to help prevent recurrence.
Chemotherapy treatment normally lasts for three months to a year. Mainly targeted at patients with rectal cancer, radiotherapy is given five times a week for a total of six weeks. Some of the latest radiotherapy technologies such as Tomotherapy can reduce the side effects remarkably, by adjusting the size, shape and intensity of the radiation beam to accurately target the size, shape and location of the patient’s tumour and minimize the damage to surrounding tissue.
In addition, for patients with stage II and III rectal cancer, treatment plans that combine chemotherapy and radiotherapy, known as chemoradiotherapy is recommended prior to the surgery. Not only can it reduce the size of the tumour and the risk of recurrence, but it also reduces the likelihood of the patient requiring a permanent stoma after the surgery.
Before the surgery, one of the treatment options is to combine chemotherapy with the “Watch-and-Wait” approach using MRI and colonoscopy. This method monitors the development of the disease, delays and even avoids the application of a surgical procedure. For patients who are younger or whose tumour is located closer to the anus, this combined treatment method can avoid the complete removal of the anus and sphincter and the creation of a stoma, allowing them to discharge waste as they normally would and thus greatly improves their quality of life.