The medical oncologists at the Duke Cancer Institute routinely integrate the newest chemotherapeutic and targeted agents into standard drug regimens to achieve a better response, fewer side effects, improved quality of life, and a greater chance for cure.

Chemotherapy uses drugs to kill cancer cells or stop them from growing. The medical oncologists work in multidisciplinary teams with colleagues from radiation oncology, surgery, gastroenterology, pathology, and radiology to provide the highest quality integrated care.

Systemic chemotherapy uses drugs that are given via a vein or by mouth, treating the whole body. Regional chemotherapy is injected into an artery to treat only one part of the body. For instance, chemotherapy may be infused directly to the liver (hepatic artery infusion) if colon cancer has spread to the liver.

For rectal cancer, chemotherapy is often combined with radiation. Duke physicians are leading the way in the use of pre-operative chemotherapy and radiation (neoadjuvant chemotherapy) to shrink rectal tumors before surgery.

To treat colon cancer, chemotherapy may be used if the cancer has spread beyond the colon wall or to lymph nodes. For people with stage II or III colon or rectal cancer, chemotherapy after surgery may help prevent the cancer from coming back.

For people with very advanced cancer, chemotherapy may be used to shrink tumors, which will help relieve symptoms.

Side Effects of Chemotherapy

Chemotherapy drugs kill cancer cells, but they can also kill normal cells, which can cause some side effects. Side effects vary depending on the type of drug used. Your doctor will manage your regimen to reduce side effects as much as possible.

Side effects of chemotherapy drugs typically used for colorectal cancer can include:

• Nausea
• Diarrhea 
• Low white blood cell count, leading to increased chance of infection
• Fatigue
• Hair loss
• Mouth sores
• Easy bruising or bleeding
• Neuropathy (loss of feeling or function caused by nerve damage)
• Hand-foot syndrome, in which redness and pain develop in the hands and feet

Expanding Treatment Through Research

Through the Duke Cancer Institute's robust clinical trials program, doctors can administer the newest experimental drugs before they become widely available to cancer patients.

For instance, our physicians led the nation in testing the targeted therapy Avastin, which shrinks tumors and extends survival in patients with colorectal cancer that has spread. Clinical studies of other novel anti-cancer targeted therapies are ongoing.

Appointments

Learn how to make an appointment at the Duke Cancer Institute.