Advanced Colorectal Cancer: What to Expect

Colorectal cancer is a tumor that starts in your colon or rectum, the end of your large intestine. When it spreads to other parts of your body -- most often to your liver, lungs, or bones -- doctors use the word “advanced” to describe it. Your doctor may also call it metastatic or stage IV disease. Although it’s outside your colon or rectum, it's still colorectal cancer, and doctors treat it with drugs for that disease.

For most people, there's no cure. But treatments can help you feel better and live longer. Scientists are also researching and testing many new therapies. Some use your body's own immune system to find and destroy cancer cells. This may be an option if other drugs don't help or stop working.

Your doctor can tell you more about new cancer treatments that may be right for you.

How Does Colorectal Cancer Spread?

Most people get the advanced form because a tumor that was treated years ago comes back. Doctors think it happens when powerful, cancer-killing chemotherapy drugs that treat the disease the first time leave a few cells behind. Even high-powered scans don’t detect them, so they can stay hidden for years before they start to grow again.  

How You’ll Feel

Some people might not have symptoms, but many do. The ones you have depend on the size of the tumor and where it has spread. Cancer in your liver may make you sick to your stomach and make your skin yellow or itchy. Tumors in your lungs can make it harder to breathe.

Treatments can almost always ease most of these symptoms. You can take nausea drugs to calm your stomach. An oxygen machine or special breathing techniques can help you get enough air.

Treatment Options

Surgery is the main treatment for cancer in the colon and rectum. But once the disease spreads, it’s often not an option.

For advanced colorectal cancer, the best treatments are ones that travel through your bloodstream, such as chemotherapy. Some chemo drugs work better together, so you may take two or three at the same time. But as these drugs fight cancer, they can also harm healthy cells. That means they can cause side effects, like hair loss and mouth sores. These problems usually go away when your chemo is over.

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Other types of cancer drugs may help, too. "Targeted" treatments are drugs that attack specific parts of cancer cells to stop them from growing or thriving. They usually cause fewer side effects than chemo drugs.

The best choice for you depends on how far the disease has spread, the side effects you might have, how healthy you are, and what you want to get out of a treatment. You may want to fight cancer as hard as you can with as many treatments as you can handle. Or you may feel better doing less.

Only you can decide what you want to do. So talk openly with your doctor about your goals for your care.

What You Can Do

Many people with advanced colorectal cancer have common concerns. Here are some tips that may help:

Stay ahead of pain. Not everyone will hurt from the disease or its treatments. But if you do, you don’t have to just grin and bear it. Talk to your doctor if you're feeling it. You may need a new drug or treatment to shrink your tumor. It may also help to add a pain specialist to your cancer care team. Other things can help, too, like massage and hot and cold packs.

Stay active. When you get enough rest and exercise, you can boost your mood and feel less tired. It may even help you live longer.

Stay connected. Cancer and your treatment can feel lonely sometimes. You may feel like no one really understands what you’re going through. It helps to reach out to others, whether it’s your friends, a counselor, or a support group of other people with colorectal cancer. They can be there when you just need someone to listen.

Stay positive. Treatments for advanced colorectal cancer are getting better all the time. And doctors are working hard to find a cure.

WebMD Medical Reference Reviewed by Louise Chang, MD on June 01, 2018

Sources

SOURCES:

American Cancer Society: "Treatment of colon cancer by stage," "When Cancer Comes Back: Cancer Recurrence," "Surgery for Colorectal Cancer," “Signs and symptoms of colorectal cancer.”

UptoDate: "Patient information: Colorectal cancer treatment; metastatic cancer."

Dartmouth Medicine: "Trial tests vaccine made from tumor cells."

Cancer Research UK: "Controlling sickness in advanced cancer."

National Jewish Health: "Lung Cancer: Lifestyle Management."

Johns Hopkins Medicine: "New Treatment and Research."

National Cancer Institute: "Metastatic Cancer Fact Sheet," "TAS-102 Improves Overall Survival in Patients with Metastatic Colorectal Cancer."

Dana-Farber Cancer Institute: "New drug combination extends survival of patients with metastatic colorectal cancer."

Cleveland Clinic.org: "Colorectal Cancer Overview."

University of Michigan Comprehensive Cancer Center: "Pain Services."

Van Blarigan, E. Journal of Clinical Oncology, April 2015.

 

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