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NCCN Guidelines for Patients



Colon Cancer, Version 1.2017


Ablation destroys small tumors with little harm to

nearby tissue. It is done by either an interventional

radiologist or a surgeon. It isn’t used often for colon


Doctors sometimes consider ablation for metastases.

Most often it is considered for colon cancer that has

spread to the liver or lung. Ablation is only an option

if all the first sites of cancer can be treated with this

method, with or without surgery or radiation.

There is more than one way to “ablate” a tumor.

Cryoablation kills cancer cells by freezing them with

liquid nitrogen. Radiofrequency and microwave

ablation kills cancer cells with high-energy radio

waves. A probe placed into the tumor emits the

waves. The probe will be guided into place with help

from an imaging test and will be removed when

treatment is done.


Embolization treats liver tumors with chemotherapy

or radioactive beads. It is done by an interventional

radiologist. A catheter will be inserted into an artery in

your leg and guided to the tumor. Once in place, the

beads will be inserted into the blood vessel.

The beads block blood flow to the tumor. Without

blood, the cancer cells “starve” and die. The

chemotherapy or radiation further damage the cancer

cells and cause the tumor to shrink.

This treatment is a type of arterially directed catheter

therapy. If radiation beads are used, it’s called

selective internal radiation therapy. Embolization is

an option for some people with liver metastases. It is

given when chemotherapy is not an option.

Clinical trials

One of your treatment choices may be to join

a clinical trial. Joining a clinical trial is strongly

supported. NCCN believes that you will receive the

best management in a clinical trial.

New tests and treatments aren’t offered to the

public as soon as they’re made. They first need to

be studied. A clinical trial is a type of research that

studies a test or treatment in people.

Clinical trials study how safe and helpful tests and

treatments are for people. When found to be safe

and helpful, they may become tomorrow’s standard

of care. Because of clinical trials, the tests and

treatments in this book are now widely used to

help people with colon cancer. Future tests and

treatments that may have better results than today’s

treatments will depend on clinical trials.

New tests and treatments go through a series of

clinical trials. These trials aim to ensure they’re safe

and work. Without clinical trials, there is no way to

know if a test or treatment is safe or helpful. Clinical

trials have four phases. Some examples of the four

phases for treatment are:



Phase I trials

aim to find the safest and best

dose of a new drug. Another aim is to find the

best way to give the drug with the fewest side

effects. These trials often involve about 20




Phase II trials

assess if a drug works for a

specific type of cancer.



Phase III trials

compare a new drug to a

standard treatment. These trials often involve

hundreds or thousands of people.



Phase IV trials

test drugs approved by the U.S.



ood and




dministration) to learn

more about side effects with long-term use.


Overview of cancer treatments





Clinical trials