The main treatment for colorectal cancer is surgery. Precisely which operation is chosen will depend on the site and severity of the tumour: some, or, in severe cases, all, of the colon and rectum may have to be removed. Surgical practice now tends towards techniques that conserve as much bowel as possible, compared with even only a few years ago.
Colostomy is an operation that may be recommended at any age, not just in high risk cases, or the elderly. Pre-operative radiotherapy may, in certain cases, be recommended to reduce the volume of the tumour. This may help the surgeon preserve the rectum and anus, and avoid a colostomy. If the rectum has to be removed, it may be possible for the surgeon to fashion a pouch using another part of the intestine (an ileal pouch), which will enable the patient to continue to eliminate faecal matter in a relatively natural way.
Chemotherapy also has a crucial role to play in advanced and inoperable disease, though it would rarely be the only treatment recommended. Finally, both pre- and post-operative radiotherapy, depending on the particular case, may also have an important role: such treatment has been shown to reduce local relapses of the disease, and improve overall survival.