Treatment and care of people with cancer is usually provided by a team of health professionals, both medical and allied health, called a multidisciplinary team.

Treatment for bowel cancer depends on:

• the stage of the disease
• the location of the cancer
• the severity of symptoms
• your general health and wishes.

Treatment may involve the following.

Surgery

Treatment for bowel cancer usually involves surgery.

Polyps and in situ cancers can often be removed during a colonoscopy (one of the diagnostic tests for bowel cancer). If examination of the removed tissue under a microscope shows that the cancer has not spread through the lining of the bowel, no further treatment is needed, but regular follow-up checks are recommended.

Surgery for stage I, II or III bowel cancer may involve removing the cancer and some nearby healthy tissue, and joining the two ends of the bowel together again. This type of surgery is called a resection with anastomosis.

If the two ends of the bowel cannot be joined, a stoma will be made. A stoma is an opening to the outside of the body, and a special bag (colostomy bag) is attached to the stoma to allow waste to leave the body. This type of surgery is called a resection with colostomy.

Some nearby lymph nodes will also be removed to check whether the cancer has spread.

Chemotherapy

Along with surgery, some people may receive chemotherapy^.

Radiotherapy

Along with surgery, some people may receive radiotherapy.

Follow-up

After treatment, you might need regular physical examinations or colonoscopies to check whether the cancer has come back (recurred). You may also have regular blood tests for cancer-related markers.

Advanced disease

People who are diagnosed with stage IV bowel cancer (where the cancer has spread to other organs) can have surgery to remove the primary bowel cancer and the secondary cancers, as well as chemotherapy or targeted therapy with monoclonal antibodies to destroy cancer cells.

If surgery is not possible, chemotherapy may shrink the tumours or slow their growth.

After treatment, you might need regular physical examinations, imaging scans or colonoscopies to check whether the cancer has come back (recurred). You may also have regular blood tests for cancer-related markers.

Recurrent and secondary cancer

Bowel cancer may recur (come back) after treatment. The cancer can recur in the bowel or somewhere else in the body, and is classified as being local or distant. Secondary cancer is when the cancer spreads to another part of the body. Secondary cancers from bowel cancer usually develop in the liver or lungs.

Treatment options for recurrent bowel cancer can include surgery, chemotherapy or targeted therapy with monoclonal antibodies.

If the cancer does not respond to treatment, supportive care or palliative care can help manage the symptoms and improve quality of life.