Chemotherapy and Targeted Therapy

Chemotherapy is the use of carefully selected drugs to destroy fast-growing cancer cells. We rarely think of chemotherapy in isolation. Instead, we design a combined plan that may also include radiotherapy (to kill off individual tumours) or targeted therapy (to block the growth signals a tumour relies on). This so-called ‘systemic therapy’ approach is relevant across bowel (colon and rectal) cancer, pancreatic cancer, liver (hepatocellular carcinoma), bile duct (cholangiocarcinoma), small-bowel and anal cancers.

We use these medicines to shrink tumours before surgery (neoadjuvant chemotherapy), reduce the chance of the cancer coming back after surgery (adjuvant chemotherapy), or control symptoms and extend life expectancy when cure is not possible (palliative, or disease-modifying, chemotherapy). Treatment is always tailored to your goals and to what we can realistically achieve.

It’s normal to worry that severe side effect are inevitable. In reality, supportive medicines along with personalised dosing and proactive monitoring mean many people keep working, exercising and living life during treatment.

The science—and art—of oncology lie in matching the right drugs to the right person at the right time, then adjusting as we go so benefits are locked in and side-effects manageable.

Chemotherapy attacks cells that divide quickly. In colorectal and pancreatic cancer, for example, it can shrink tumours to make surgery possible or safer, eradicate microscopic cancer after surgery, and prolong healthy life expectancy in more advanced disease. We use either single agents or combination regimens such as FOLFOX, FOLFIRI, CAPOX, FOLFIRINOX/FOLFOXIRI, gemcitabine based combinations, capecitabine (oral), and trifluridine/tipiracil in bowel cancer settings. Treatment runs in cycles every 2–4 weeks, with planned rest periods for recovery. Your schedule depends on cancer type, goals and how your body responds, and we adjust as needed to keep you safe and on track.

Targeted therapies block specific signalling pathways cancer cells depend on. Examples we commonly consider include antiEGFR treatments such as cetuximab and panitumumab in RASwildtype colorectal cancers, antiVEGF drugs to reduce a tumour’s blood supply, HER2directed therapy in bowel cancers, PARP inhibitors in BRCAmutated pancreatic cancer, and tyrosinekinase inhibitors (TKIs) such an lenvatinib and regoragenib for hepatocellular carcinoma or laterline bowel cancer. We base these decisions on detailed genomic testing of the tumour so we can focus on the options most likely to help you. Targeted therapies can be given alone or combined with chemotherapy to deepen and extend control of the cancer.

Immunotherapy (most often checkpoint inhibitors) helps immune cells find and attack cancer. This is particularly relevant when biomarkers predict better responses—for example mismatchrepair deficient / MSIhigh colorectal tumours, cholangiocarcinoma and hepatocellular carcinoma. Immunotherapy may be given on its own or with chemotherapy / targeted therapy, usually in outpatient infusions. If immunotherapy is suitable for you, we will discuss benefits, timelines, and how we monitor and treat immunerelated sideeffects early, so you can continue safely. You can find out more about immunotherapy here.

Your plan reflects: cancer stage, exact tumour site, overall fitness, previous treatments and, crucially, the genetic profile of the tumour. We use systemic therapy when evidence shows a real benefit—either increasing the chance of cure or improving quality and duration of life.

Depending on your case, therapy may be used alone or alongside surgery, radiotherapy (including stereotactic SABR where appropriate), and organ preserving strategies in rectal cancer.

Lines of therapy: If the cancer returns or becomes resistant to treatment, we switch to the next best option. We sequence things carefully so you receive effective choices now without closing doors later, building in breaks from treatment without compromising effectiveness. This maximises both life expectancy and quality of life, both of which are important to people with more advanced cancer.

Response assessment: We schedule scans at planned intervals and track blood tumour markers (e.g., CEA or CA199 where relevant) so you and I can see what is working—and change tack quickly if needed.

Genomic profiling: We test the tumour to reveal targetable pathways and immunotherapy eligibility. This is a key way in which we connect you to the most promising options.

Integrated care: Chemotherapy and targeted therapies work better, and cause fewer side effects, in people who make key changes to lifestyle that help their body fight the cancer and cope with the treatment. I believe in discussing this in at least as much detail as the chemo itself!

World-class care is about how treatment is delivered as much as what is delivered. With my team you receive:

• Rapid access to consultation and your first cycle—no unnecessary delays.
• Treatment in a safe, comfortable and supportive environment with expert oncology nurses and pharmacists able to focus on you without distractions.
• Personal supervision I remain closely involved, adjusting doses and schedules to keep treatment safe and effective.
• Joined up support – We coordinate molecular testing, PICC/port insertion, nutrition, psychological care and survivorship planning so everything works as one.
• 24/7 advice line for urgent concerns plus easy access to in-person or video review when you need it.

Whether you’re insured or self funding, we provide clear costs from the outset and handle authorisation so admin doesn’t slow you down. The priority is simple: speed, precision and compassionate continuity from first contact to followup.