If colorectal cancer has not spread beyond the colon or lymph nodes, surgical removal of the tumor is the most common treatment. Surgical procedures for rectal cancer are more complex than for colon cancer. In rectal surgery more tissues and muscles related to urinary and sexual functions are involved.

Patients with a strong family history of cancer, intractable inflammatory bowel disease, familial adenomatous polyposis (FAP), or hereditary nonpolyposis colon cancer (HNPCC) may elect to have their colon removed in advance of developing problems. This procedure can sometimes be done laparascopically, with smaller incisions and shorter recovery time.