Colon and rectum (colorectal) cancer drugs

Cancer that attacks the colon (colon) and / or rectum is known as colorectal cancer. This cancer can lead to death if not treated properly. The reason is, cancer cells can spread and kill the surrounding healthy tissue. Fortunately, there are a variety of drugs and treatments available that can relieve symptoms of the colon (colon) and rectum and kill these cancer cells.

Drugs and other types of colorectal cancer treatment

Although it can cause death, colon or rectal cancer patients can actually recover from this disease. Especially if the diagnosis of colon cancer is done at an early stage or has not yet attacked the surrounding vital organs.

Cure for colorectal cancer (colon / colon and rectum) can include the use of drugs or other medical procedures. Let's discuss one by one the following cancer treatments that attack the digestive system.

1. Chemotherapy

Chemotherapy is one way of treating colon and rectal cancer with drug therapy that destroys cancer cells.

Chemotherapy can be obtained in various ways, namely by inserting it directly into the bloodstream by injection into a vein or by drinking it. It can also be given directly into an artery leading to the part of the body affected by the tumor.

Chemotherapy drugs work to attack cells that are dividing rapidly so that they are powerful enough to fight cancer cells. Reported by the American Cancer Society, several types of drugs commonly used in chemotherapy for colon and rectal cancer include:

5-Fluorouracil (5-FU)

Fluorouracil is a chemotherapy drug that acts as an antimetabolite that is similar to normal body molecules, but has a slightly different structure. This difference can stop cancer cells from working and repair DNA.

Irinotecan

Irinotecan is a drug used for chemotherapy for colon and rectal cancer, which works to interfere with the growth and spread of cancer cells.

Oxaliplatin

This oxaliplatin called Eloxatin can stop cancer cells from dividing into new cancer cells and killing them.

Capecitabine

Capecitabine, also known as Xeloda, works like fluorouracil, which stops cancer cells and repairs DNA.

Chemotherapy for colon cancer can have various side effects, depending on the type of drug and how long the drug has been used.

Common side effects include hair loss, sores in the mouth, nausea and vomiting, diarrhea, easy bruising and infection, severe body fatigue and nerve damage.

2. Cancer surgery

The next way to deal with colorectal cancer (colon / colon or rectum) is surgery. This medical procedure is the main treatment for early-stage colorectal cancer. Therefore, it is likely that there is no cancer treatment for the colon and rectum without surgery, even if the patient is given medication.

The goal of this treatment is to remove cancer cells that have formed tumors in the body. However, the type of surgery will be adjusted according to the stage of the cancer the patient has and its location.

Here are some types of surgery that are performed as a way to cure colon and rectal cancer:

Polypectomy and local excision

Early stage colorectal cancer and abnormal polyps can be treated with polypectomy. Polypectomy itself is a medical procedure using a flexible tube equipped with a camera that is inserted through the rectum until it reaches the large intestine.

Additionally, your doctor may recommend local excision. This procedure uses a colonoscope to remove a small tumor in the lining of the intestine along with a small amount of surrounding healthy tissue. Then, the pieces of cancer cells in the intestine will be removed from the body and given painkillers.

Colectomy

Colectomy is an operation to remove all or part of the colon, sometimes the lymph nodes are also removed. Bowel cancer treatment is carried out in two ways, namely through one long incision in the abdomen (open colectomy) and using a small incision laparoscopy.

If a tumor in the intestine causes a blockage, the doctor will insert a stent (perforated metal or plastic tube) into the colon before surgery. The goal is to keep the large intestine open and reduce blockage. However, if the stent cannot be inserted, surgery on the large intestine must be performed immediately.

Local transanal resection and transanal endoscopic microsurgery

This treatment for rectal cancer is usually performed when the tumor is relatively small and the location is not far from the anus. The surgeon will give an anesthetic, then cut all the layers that are affected by cancer and close it again.

If the above procedures are not possible, the surgeon will opt for transanal endoscopic microsurgery. A special instrument will be inserted through the anal and into the rectal area.

Low anterior resection (LAR) and proctectomy

Colorectal cancer stages 1,2 and 3 are mostly treated with the LAR procedure, which is the removal of the rectum containing cancer cells. Then, the large intestine is connected directly to the rest of the healthy rectum.

If this method is not possible, the doctor will recommend a proctectomy, which is the removal of the rectum as well as the lymph nodes near the rectum.

Abdominoperineal resection (APR)

Colon cancer surgery involves a LAR procedure, by making an incision in the stomach or around the anus where the patient was previously injected with an anesthetic.

This procedure is performed if the cancer has invaded the sphincter and levator muscles, which are the muscles that keep the anus closed and prevent feces from leaking out and control the flow of urine.

After colon and rectal cancer surgery, you may need to stay hospitalized for a few days and follow up to 3-6 weeks of remedial care at home.

3. Radiotherapy

Radiotherapy is a treatment option for colon and rectal cancer in addition to chemotherapy. The goal is to shrink the tumor and kill any remaining cancer cells. Colon cancer treatment can be done before surgery or after.

Medications that rely on X-rays can cause side effects, such as skin irritation, diarrhea, painful bowel movements, and intestinal incontinence (leaky bowel) and bladder problems.

4. Targeted therapy

Apart from chemotherapy, colon cancer treatment that focuses on drugs is targeted therapy. This therapy targets to interfere with the formation of blood vessels that flow to tumors and proteins that help cancer growth.

Examples of drugs commonly used in targeted therapy for colorectal cancer are:

Bevacizumab (Avastin).
Ramucirumab (Cyramza).
Ziv-aflibercept (Zaltrap).
Cetuximab (Erbitux).
Panitumumab (Vectibix).
Regorafenib (Stivarga).

This drug is given by injection into a vein, once every 2-3 weeks. In many cases, it is combined with chemotherapy drugs in stage 4 colon cancer patients. However, this treatment also causes side effects such as fatigue, headaches, decreased white blood cell counts, and diarrhea.

5. Immunotherapy

Immunotherapy is a cancer treatment that focuses on enhancing the immune system to better recognize and destroy cancer cells. In colon and rectal cancer, the drugs used in immunotherapy are:

Immune checkpoint inhibitors

This drug is given to patients whose tumors are still growing despite chemotherapy.

PD-1 inhibitors

The drug, which consists of Pembrolizumab (Keytruda) and nivolumab (Opdivo), helps T cells not attack other cells of the body, and only attack cancer cells.