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Standard Treatments

Colorectal cancer is cancer  offsite linkthat generally occurs in the colon or rectum. (For a general overview, click here).

Standard treatment for Stage III colon cancer includes each of the following:

  • Surgery for Stage III rectal cancer (also known as resection). To learn about this surgery, click here.
  • Chemotherapy which is generally a combination of drugs known together as FOLFOX or a combination of other drugs known together as CapeOx. 
    • For information about FOLFOX, click here. 
    • For information about CapeOx, click here
    • For information about practical aspects of chemotherapy in general, click here.

Complementary Treatments: Complementary therapies can help reduce symptoms or side effects and generally make you feel better Complementary treatments include acupuncture, massage, meditation and relaxation techniques as well as other treatments. The key word here is “complementary” because these treatments should not be used as an alternative to the above mentioned treatments. There is no scientific proof that any of these treatments cure rectal cancer. In fact, they can even make matters worse.

Be sure to telll your doctor about any complementary therapies you use and/or are considering. Some may affect standard treatment or cause serious side effects.(For more information, click here.)

Unless treatment starts immediately after a decision is made, learn about steps to take between making the decision and the actual start of treatment by clicking here.


  • If you have to choose between treatments, consider getting a second opinion from an NCI designated Comprehensive Cancer Center. offsite link  (For pracical tips about second opinions, click here.)  Second opinions are usually covered by health insurance - and are not expensive if not covered. Alternatively, if you are looking for criteria to help make a decision, see:
  • If existing treatments are not adequate, cutting edge drugs are available through clinical trials (controlled studies involving patients). There may also be treatments in use in other countries that may be of interest. For additional information, see the document in “To Learn More.”

To Help Decide Which Treatment Is Best For You

Find out how much time you have to make a decision.  Whatever your situation, ask the doctor who diagnosed you how long you have to make a treatment decision. Then take as much time as you need within that time frame before making a decision.

Gather all the information you reasonably can:

If the doctor doesn't have time to answer all your questions during an appointment, ask when you can ask your remaining questions. For example, on what day and at what time should you call? Or, when can you see the doctor again? NOTE: When discussing continence, ask the doctor for his or her definition. (For example, some doctors consider a person  to be continent if he or she wears no pad or if he or she wears a pad that is dry.)

In addition, consider the following resources to help make a treatment decision:

  • National Comprehensive Cancer Network (NCCN) publishes the gold standard treatment guidelines for colorectal cancer.  Currently, only a guide for professionals is available. There is currently no patient friendly guide. You can access NCCN guidelines for free at: offsite link
  • Colon Cancer Alliance provides a Colorectal Cancer Profiler Tool to help make treatment decisions.  Click here offsite link.
  • Independent services are available which will research all treatments available for your particular situation (including cutting edge treatments only available through controlled studies known as clinical trials).  Some of the services will even offer their opinion about which treatment is best for you based on your medical condition, medical history and your individual priorities.  For a list of services, click here.

We provide an evaluator to help you compare treatments to decide which one is best for you if necessary. Click here.

Keep in mind that cutting edge treatments are available through clinical trials. Clinical trials are carefully controlled research studies that are done with patients who volunteer for them. At least raise the question with your oncologist about treatments available through clinical trials. Some studies are only open to patients who are "treatment naive" - people who have not yet had therapy for colorectal cancer. To learn about clinical trials, click here.

Get a second opinion. Doctors who specialize in colorectal cancer are used to patients requesting second or even third opinions and will provide the information and copies of tests you need. For information about a second opinion, including how to get one on a timely basis, from whom, what to do if there are conflicting opinions, and how to pay for them, click here.  

Talk with your partner before making a final decision – if for no other reason because any treatment may lead to some degree of diarrhea and possibly a temporary or permanent ostomy. (Yes, there are methods to dealing with these situations). See “To Learn More.”

If You Are Going To Have External Radiation

  • If you want to have children in the future, ask the doctor whether radiation could affect your ability to have children. If so, consider banking your sperm or eggs before the treatment starts. (For more information, click here)
  • Set a treatment schedule that works for you as well as the facility. As a general matter, radiation treatments are scheduled at the same time 5 days a week for a period of weeks. Set a time slot that fits for your life. If the time isn't immediately available, perhaps one will become available in time. Check to find out how long you can wait to start treatment without affecting the effectiveness of your treatment. If the timing doesn’t work, consider using another radiation facility in your area.
  • Take care of the medical prep on a timely basis.
    • Expect to meet with your radiation oncologist before treatment starts. Also expect that he or she will consult with other members of your treatment team. Before treatment, the doctor will also examine you thoroughly and will review your medical reports.
    • Stay on top of doctors receiving reports from other doctors. Find out what date the doctor expects to receive a report. Check that day to be sure the report is received. If not, call the doctor’s office that was to forward the report to follow-up. If necessary, physically go and pick up the report and take it to the appropriate doctor.
  • Schedule a dental check up. Oral infections can worsen the effects of radiation.
    • Speak with your oncologist about possible oral complications from your treatment and what, if anything, your dentist should focus on prior to treatment.
    • Get an examination of your mouth, teeth and jawbone to check for potential problems that may arise during treatment.
      • Tell the dentist you are about to have treatment for colorectal cancer and the specific treatment(s) you have agreed to.
      • Mention to your dentist the risks for oral complications your doctor told you about.
      • If you have issues that could become a problem during treatment, take care of them now. Find out from your dentist how much time is needed for your mouth to heal properly. It is preferable for healing to be complete before treatment begins.
    • If your doctor recommends that you speak with a dental oncologist (a dentist who is trained in dental and oral care for people with cancer): Use the same technique to find the right dental oncologist as is recommended for choosing any medical specialist. (For information, click here). . You can locate a dental oncologist through any of the following:
      • A referral from your oncologist.
      • National Cancer Institute, offsite link or Tel.: 800.422.6237.
      • National Comprehensive Cancer Network, offsite link, or Tel.: 215.690.0300.
  • Practice good oral hygiene. Good oral hygiene will reduce your chances of getting tooth decay, mouth sores and, most important, infections. Experts recommend that you brush your teeth after every meal and at bedtime. Use a soft toothbrush and toothpaste with fluoride in it.  Floss once a day.
  • Find out if there are any medications, supplements, herbs or vitamins you take that should be discontinued during treatment. If there are, check with the doctor who prescribed them to let him or her know what is happening and find out if you should be doing something else during treatment.
  • Learn about and prepare for possible side effects. For instance:
    • Speak with the radiologist about creams to purchase to reduce possible skin soreness. Test a small amount to be sure you don't have any adverse effects.
    • Fatigue generally accompanies radiation treatment. Start making room in your schedule for rest. For information on coping with fatigue, click here
    • Get a prescription for nausea “just in case.”  If you have a prescription, you can fill it without delay if the need arises. Prescriptions don't cost anything until you have them filled.
  • If you smoke, use the treatment as a trigger to stop. 
    • Stopping can help improve the body’s response to treatment, and lessen complications and side effects.
    • If you quit permanently, stopping can decrease the risk of recurrence and enhance the likelihood of survival.
    • For information about stopping smoking, click here
  • If you are around second hand smoke try to eliminate your exposure. Second hand smoke is as dangerous to your health as smoking.
  • If you use recreational drugs, let your doctor know. They may interfere with treatment.
  • Consider taking a tour of the area where radiation will be administered and any other location where you will be spending time. This way you will know what to expect. You'll also get a better idea of what to bring with you to make yourself comfortable. (For information about what to expect during treatment, click here.
  • It may make it easier for you if you line up a family member or friend to go with you to the first treatment. After that it may be easier if you go to treatments alone. Going alone makes going for treatment more like going to a standard doctor's appointment. You will likely find other people going through the same treatment with whom to have an informal support group.
  • Think about how you are going to get to and from appointments. If needed, American Cancer Society can help arrange transportation with its group of volunteer drivers. Call 800.ACS.2345. The more notice you give the Society, the more likely it can find a volunteer to fill your needs. The Society can also point you to available public transportation in your area.
  • Ask your doctor about changes to start making in your diet to build your system with nutrients that the treatment may effect. The doctor may recommend you speak with a nutritionist/dietitian. Perhaps you should also be taking a multi-vitamin and/or supplements.
  • Stock up on single portions of your favorite comfort foods, including some in your freezer that you can defrost as needed. When you freeze foods for this period, make the portions smaller than usual for those occasions when you don't feel like eating a lot.
  • If you have children, and haven't told them yet about your condition and/or treatment, now is the time to do it in an age sensitive manner. See the document in "To Learn More."
  • Schedule doctor appointments for your convenience.
    • An appointment early in the day or at the beginning of that part of the day when the doctor sees patients generally gets you in and out quickly. Doctors' schedules tend to back up as the day progresses.
    • If you have appointments with different doctors and/or tests coming up, consider scheduling them for the same day or only setting doctor appointments for the same day every week.
  • Last, but not least, check your health insurance policy to find out if prior approval is necessary and to determine how much money, if at all, you will be out of pocket. Start thinking about how to pay those costs. If you don't have health insurance, start thinking about how to pay for the treatment. For information about these subjects, see the documents in "To Learn More."

During And After Treatment

For information about: