Colorectal Cancer, Metastatic or Recurrent

Chemotherapy is the use of drugs to control cancer's growth or relieve symptoms. Often the drugs are given through a needle in your vein, and your blood vessels carry the drugs through your body. Sometimes the drugs are available as pills you can swallow. Sometimes they are given through a shot, or injection. For colorectal cancer that has spread to the liver, researchers are studying hepatic intra-arterial chemotherapy. This delivers drugs directly to the liver.

Several drugs are used to treat metastatic or recurrent colorectal cancer. Drugs are also available to treat side effects such as nausea.

Medication Choices

The most commonly used drugs for the treatment of colorectal cancer are:

• Bevacizumab (Avastin).
• Capecitabine (Xeloda).
• Cetuximab (Erbitux).
• Fluorouracil (5-FU).
• Irinotecan (Camptosar).
• Leucovorin.
• Oxaliplatin (Eloxatin).

Cancer drugs are often used in combination. For example, a treatment called FOLFOX4 uses oxaliplatin, leucovorin, and fluorouracil, while the treatment called FOLFIRI uses folic acid, fluorouracil, and irinotecan. There are several of these specific drug combinations.

Panitumumab (Vectibix) is another drug recently approved by the U.S. Food and Drug Administration (FDA). It is used for colorectal cancer that has spread and has not gotten better during or after treatment with other drugs. Panitumumab seems to delay growth and spread of the cancer by about 5 weeks, but it may not increase survival.

Your doctor may prescribe medicines to control nausea and vomiting. These drugs include:

• Aprepitant (Emend), which is used in combination with ondansetron and dexamethasone as part of a 3-day program.
• Metoclopramide (Reglan).
• Phenothiazines, such as promethazine hydrochloride (Phenergan) and prochlorperazine (Compazine).
• Serotonin antagonists, such as ondansetron (Zofran), granisetron (Kytril), or dolasetron (Anzemet). These medications prevent nausea and vomiting caused by chemotherapy more effectively when they are combined with corticosteroids, such as dexamethasone (Hexadrol).

Clinical trials that test new drugs are ongoing. Talk with your doctor about participating in a clinical trial.

What To Think About

Drugs may not cure metastatic or recurrent colorectal cancer, but they can help you feel better and live longer by slowing the cancer's growth.

Talk to your doctor about drugs to help you manage pain and other symptoms that may accompany cancer. For more information, see the topic Cancer Pain.