Metastatic Colon Cancer

by Garreth Myers

Colon cancer is the second most common form of cancer resulting in mortality. It is associated with various environmental and demographic risk factors. It is presumed that the environmental factors enhance the risk of the genetic mutations responsible for colon cancer. However, this fact is not yet supported by any proven studies of the molecular mechanisms associated with it. Demographic factors also account for the incidence of colon cancer. These include the dietary differences between nations and factors such as industrialization. The occurrence of colon cancer also rises sharply with age, starting from 50 years.  

The most common sites where the metastases develop are the liver and the regional lymph nodes. In addition, the less common sites are adrenals, lungs, peritoneum, and pelvis. These sites usually get affected only after the colon cancer spreads to the liver or the lymph nodes.

The symptoms of metastatic colon cancer are not obvious in the early stages and manifest only in the later stages. The symptoms depend on various factors, such as the specific location and size of the cancer and the present location of the metastases. The symptoms of colon cancer can manifest in the most mundane manner, as an abnormal change in bowel habits. This may either be associated with diarrhea or constipation. Some of the common signs include abdominal pain, unexplained weight loss, and rectal bleeding. The less common symptoms include nausea, vomiting, loss of appetite, and abdominal distention.

Metastatic colon cancer is also known as stage IV colon cancer and is divided into two basic groups. In one group, the cancer spreads to multiple locations, and in the other, the cancer metastasizes to a single site. The treatment procedures consist of surgery, radiation, targeted therapy, chemotherapy, or a combination of these techniques.

For patients suffering from widespread metastatic colon cancer, the FDA approved drug fluorouracil (5-FU) is used as a standard treatment. 5-FU is typically administered along with leucovorin. Leucovorin is a drug similar in structure and function to the vitamin folic acid, and it enhances the anticancer effects of fluorouracil. Targeted therapies are also used in the treatment of metastatic colon cancer. These therapies work by inhibiting the pathways of the cancer cell growth. Some of the therapies reduce the blood supply to the cancer cells and inhibit their growth. Some block the growth signals from reaching the cancer cells. And, some targeted therapies stimulate the immune system in order to identify and attack the cancer cells.

For the patients whose colon cancer has been metastasized to a single site, surgery is the most preferred treatment option to remove the metastases. The liver is the most common site for metastatic colon cancer. In some cases of liver metastases, surgery may not be possible due to the location and size of the cancerous tissue. In these cases, alternative therapies such as chemotherapy, radiation therapy, cryotherapy and radio frequency ablation may be considered. Not much information is available about the benefits and risks of the above therapies, but research in these areas continues to advance our knowledge and understanding of the disease and treatment options.

The prognosis of the metastatic colon cancer is dependent on factors like the location of the original cancer and the amount to which it is spread to the organ. In some cases, the metastasis can be cured by surgery. Surgery could be done if there are limited numbers of lesions and there is no major vascular involvement in the organ. According to a report published by The University of Chicago Medicine, surgery has resulted in five years survival rates of 25 to 40 percent of patients with hepatic metastases. Some complex cases could not be cured by surgery. However, the advanced techniques discussed above can help shrink the tumors, relieve the symptoms and increase the life expectancy.


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