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Colorectal Cancer Treatment by Stage


Stage IV Colorectal Cancer

Stage IV colorectal cancers have spread outside the colon to other parts of the body, such as the liver or the lungs. Cancer that has spread is also called "metastatic." The tumor can be any size and may or may not include affected lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).

Treatment may include:

  • Removal of the cancer surgically or another surgical procedure to bypass the colon cancer and hook up healthy colon (an anastomosis).
  • Surgery to remove parts of other organs such as the liver, lungs, and ovaries, where the cancer may have spread.
  • Chemotherapy to relieve symptoms and improve survival.
  • Erbitux, Avastin, or Vectibix in combination with standard chemotherapy, depending upon tumor characteristics.
  • Zaltrap is a drug also approved for use with chemotherapy in cases where the cancer has progressed or is resistant to treatment.
  • Stivarga is a targeted therapy approved in patients whose cancer has progressed after previous therapy.
  • Clinical trials of new chemotherapy regimens, or immunological therapy.
  • Radiation to relieve symptoms.

The five-year survival rate for stage IV colon cancer is nearly 8%.

Recurrent Colorectal Cancer

Recurrent colorectal cancer is cancer that returns after surgical treatment, and with or without adjuvant chemotherapy. The recurrence may be local or near the area of the initial cancer, or the cancer may return in distant organs.

The liver is involved in up to 2/3 of patients who die from colorectal cancer.

Recurrence is most likely in patients with more advanced colorectal cancer, at the time of original diagnosis.

Treatment may involve:

  • Surgery to remove the recurrences. This may lengthen life span and in some cases, this is curative when given with chemotherapy.
  • If the metastases can't be removed, chemotherapy is the main treatment.
  • Clinical trials are another option.



WebMD Medical Reference

Reviewed by Sujana Movva, MD on July 27, 2014
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