Decisions about chemotherapy for bowel (colorectal) cancer

Chemotherapy is a treatment which uses drugs to destroy cancer cells. Because cancer cells are dividing quickly they are particularly susceptible to chemotherapy which disrupts the growth of cancer cells. It can be given in tablet or capsule form but more commonly it is given into a vein (intravenously).

Adjuvant chemotherapy is chemotherapy used in addition to other treatments, such as surgery or radiotherapy. Its aim is to prevent the cancer coming back once the original tumour has been destroyed or removed. Adjuvant chemotherapy may be prescribed if cancer has spread to the lymph nodes or if it is unclear whether after the main treatment any cancer cells have been left behind.

People who are offered chemotherapy as a precaution have to decide whether the potential benefits of treatment outweigh the possible side effects. One woman describes the decision-making process she went through before choosing to have chemotherapy. A man, who supports other cancer patients on a voluntary basis, thought that the choice became obvious if you made a list of the pros and cons:

Describes how she decided to have chemotherapy.

Age at interview 74

Gender Female

Age at diagnosis 68

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He feels that making a list of the pros and cons of chemotherapy makes the decision obvious.

Age at interview 69

Gender Male

Age at diagnosis 65

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Stephen describes the types of chemotherapy he had after his surgery.

Age at interview 19

Gender Male

Age at diagnosis 15

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While no one we talked to who had been offered chemotherapy refused it, several people who accepted or agreed to continue with the treatment had done so partly out of a sense of duty to others. One woman was so grateful for the help she had received from her medical team that she felt she would be letting people down if she refused, and a man facing a decision about chemotherapy was moved by his concern for his wife:

Her decision to have chemotherapy was connected to her gratitude to her medical team.

Age at interview 68

Gender Female

Age at diagnosis 67

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Continued with chemotherapy to help reduce his wifes intense worry about him.

Age at interview 60

Gender Male

Age at diagnosis 60

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Two younger patients faced difficult decisions about chemotherapy because of its potential impact on their families and future lives. One woman had been pregnant at the time of her illness and faced chemotherapy with a new baby at home. She explains how she chose a course of action. Another young woman describes her distress at the prospect of chemotherapy leaving her infertile, and how a second opinion offered an alternative:

She had to choose a course of action that would suit her as a new mother.

Age at interview 35

Gender Female

Age at diagnosis 32

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She feared that chemotherapy would leave her infertile until an alternative drug was proposed.

Age at interview 33

Gender Female

Age at diagnosis 28

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Daily living with a stoma

People with colostomies or ileostomies can eat the same foods, wear the same clothes, travel, and participate in the same sports and physical activities as...