Treatment for metastatic bowel cancer

Treatment options for metastatic bowel cancer

Metastatic bowel cancer is cancer that started in either the back passage (rectum) or large bowel (colon) and has spread to another part of the body.

It is also called advanced cancer.

Doctors might also describe your bowel cancer as advanced if both:

you’re not able to have surgery to remove the cancer
the cancer has not spread to another part of the body

Deciding about treatment can be difficult when you have cancer that has spread. Treatments such as chemotherapy, targeted cancer drugs, immunotherapy and radiotherapy can help to reduce symptoms and might make you feel better. But they also have side effects that can make you feel unwell for a while.

You need to understand:

the aim of the treatment
how it might affect your quality of life
possible side effects

Your doctor or specialist nurse can talk to you about the benefits and possible side effects. You can ask them questions.

You might also find it helps to talk things over with a close relative, a friend or a counsellor at the hospital.

We're here for you if you or someone close to you has cancer. You can call our Cancer Research UK nurses on 0808 800 4040, from Monday to Friday, 9am to 5pm.

Types of treatment

Treatment depends on:

the size of the cancer and where it is in the body
how far it has spread
the treatment you have already had
your general health

To shrink your cancer, slow its growth and relieve your symptoms your doctor might recommend:

Surgery

You might have surgery to treat a blocked bowel. And sometimes you can have surgery to remove small areas of cancer that has spread to the liver or lungs.

Chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream.

Chemotherapy for metastatic bowel cancer can relieve the symptoms. It can also control the cancer and improve your quality of life for a time.

Find out about chemotherapy for metastatic bowel cancer

Radiotherapy

Radiotherapy uses high energy rays to destroy cancer cells. You might have radiotherapy to shrink your cancer and help relieve symptoms.

Targeted and immunotherapy drugs

Targeted cancer drugs work by targeting the differences between cancer cells and normal cells that help them to grow and survive. Other drugs help the immune system attack cancer. They are called immunotherapies.

Some drugs have a very specific target, and your team might need to do extra tests on the cancer to see if a particular drug might help. Some drugs work in more than one way. They can shrink or slow the growth of metastatic bowel cancer.

Having treatment as part of a clinical trial

Doctors are always trying to improve treatments and reduce side effects. Your doctor might ask you to take part in a clinical trial as part of your treatment. This might be to investigate a new cancer treatment or to look at different combinations of existing treatments.

Your doctor will tell you if there are any trials that you can enter.

Get information on research and clinical trials for bowel cancer

Controlling symptoms

Bowel cancer that has spread to other parts of the body might cause symptoms such as pain. The symptoms you have depend upon where the cancer has spread to.

Treatment to control symptoms might include:

a tube (stent) to relieve symptoms from a bowel blockage
a tube to drain fluid from a swollen tummy (abdomen)
medicines to help control symptoms such as pain or feeling sick

Chemotherapy, surgery, radiotherapy and targeted and immunotherapy drugs can all help to control symptoms as well.

Get information on controlling symptoms of metastatic bowel cancer

Your choices

Your doctor might offer you a choice of treatments. Discuss each treatment with them and ask how they can control any side effects. This helps you make the right decision for you. You also need to think about the other factors involved in each treatment, such as:

whether you need extra appointments
if you need more tests
the distance you need to travel to and from hospital

You might have to make further choices as your situation changes. It helps to find out as much as possible each time. You can stop a treatment whenever you want to if you find it too much to cope with.

If you decide not to have treatment

You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness or pain.

Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to give you support at home.

See what support you can get

Last reviewed: 28 Mar 2025

Next review due: 28 Mar 2028

Treatment for metastatic bowel cancer

The aim of treatment for metastatic bowel cancer is usually to reduce symptoms, make you feel better and sometimes help you live longer.

Living with metastatic bowel cancer

Find out more about Living with metastatic bowel cancer

Coping and support when you have metastatic bowel cancer

If you have metastatic bowel cancer there is information and support available to you, your family and friends.

Research and clinical trials for bowel cancer

All treatments must be fully researched before they can be adopted as standard treatment for everyone. Find out about research into bowel (colorectal) cancer, as well as how to take part in clinical trials.