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NCCN Guidelines for Patients



Colon Cancer, Version 1.2017


Overview of cancer treatments

Radiation therapy

During treatment, you will lie on a table as you did for

simulation. Devices may be used to keep you from

moving. This helps to target the tumor. Radiation

beams are aimed with help from ink marks on your

skin or marker seeds in the tumor.

You will be alone in the treatment room. A technician

will operate the machine from a nearby room. He or

she will be able to see, hear, and speak with you at

all times. As treatment is given, you may hear noises.

You will not see, hear, or feel the radiation. One

session can take less than 10 minutes.

Intraoperative radiation









herapy) delivers

radiation inside your body at the time of an operation.

Different methods can be used. However, the usual

method involves a device that is placed where the

tumor was. The radiation kills remaining cancer cells

in the tissue that was near the tumor.

IORT is a one-time treatment that is given while

you are still asleep. It can deliver a radiation dose

similar to EBRT or deliver extra radiation. This extra

radiation is called a boost. IORT uses radiation made

of electrons. Electrons do not travel far and are less

likely to harm the tissue beneath the treatment site.


Some cancer centers do not have an IORT machine.

In this case, a boost of radiation can be given with

EBRT or brachytherapy. Brachytherapy delivers

radiation through radioactive objects that are placed

where the tumor was. The objects remain in your

body for a short period of time following surgery.

Brachytherapy is rarely used for colon cancer.

Side effects

Side effects from radiation therapy differ among

people. Factors like method, treatment site, radiation

dose, and length of treatment play a role. However,

many people feel tired (fatigue) no matter the

radiation method or site.

When EBRT is used, skin damage is also common

right after treatment. Your skin will heal shortly after

treatment ends. You may also have short-term hair

loss, but only where treated.

Chest radiation can cause a dry cough or a sensation

of a lump when you swallow. Radiation near your

belly can cause nausea and maybe vomiting. When

given between your hip bones, radiation can cause

frequent bowel movements. Your stool may be loose

(diarrhea) and you may have cramps or pain in your


IORT and brachytherapy can cause side effects

like EBRT. You may feel nauseated and may vomit.

Frequent bowel movements and urination may occur.

Late side effects of radiation can happen. Again,

the effects depend on the treatment site. Examples

include lung scarring, heart disease, infertility, and

second cancers.

Not all side effects of radiation are listed here.

Please ask your treatment team for a complete list of

common and rare side effects. If a side effect bothers

you, tell your treatment team. There may be ways to

help you feel better. There are also ways to prevent

some side effects.