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Treatment decisions for early bowel cancer

Find out about how your doctor decides which treatment you need for early bowel cancer, the types of treatment you might have and treatment by stage.

This page is about treatment decisions for early bowel cancer.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

Treatment overview

The main treatments are:

  • surgery
  • chemotherapy
  • radiotherapy 

Surgery for early bowel cancer

Most people with early bowel cancer have surgery. You surgeon may be able to take out all of your cancer. For some people this might cure the cancer. This means their cancer never comes back. 

Your doctor might suggest you also have chemotherapy or radiotherapy to stop the cancer coming back after surgery.

Chemotherapy for early bowel cancer

People with very early bowel cancer (stage 1) do not need chemotherapy after surgery.

Chemotherapy can be used for cancer in any part of the large bowel (colon) or back passage (rectum). It aims to kill any cells left behind after your operation. This is called adjuvant chemotherapy. 

Your surgeon might suggest chemotherapy after surgery as part of a clinical trial if you have a stage 2 bowel cancer. You might be at higher risk of cancer coming back if cancer cells are found in lymph nodes or blood vessels near the bowel. Your doctor may offer chemotherapy if your cancer has grown into organs or structures next to the bowel. 

Most people with stage 3 bowel cancer will have chemotherapy after surgery. You might have this as tablets or through a drip into your vein. You may have chemotherapy as part of a clinical trial.


Doctors don't often use radiotherapy to treat cancer in the large bowel (colon). 

Radiotherapy is used to treat cancer of the back passage (rectum). You might have radiotherapy before sugery to shrink the cancer. This is called neoadjuvant radiotherapy. 

You might also have radiotherapy to stop cancer of the back passage (rectum) coming back after surgery. This is called adjuvant radiotherapy. 

Your doctor might suggest having radiotherapy and chemotherapy together. This is called chemoradiation.

Other treatments for early bowel cancer

Clinical trials are researching using biological therapies called monoclonal antibodies to treat early bowel cancer. 

Monoclonal antibodies recognise and attach to specific proteins produced by cells. Each monoclonal antibody recognises one particular protein. They work in different ways depending on the protein they are targeting. So, some monoclonal antibodies might block particular proteins that encourage a cancer to grow and others might stop cancer cells from making their own blood supply.

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Information and help

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About Cancer generously supported by Dangoor Education since 2010.