What is metastatic colorectal cancer?

Article written by Master, Doctor Mai Vien Phuong - Gastroenterologist - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Colorectal cancer is cancer that begins in the colon or rectum. This is a cancer that develops from stage 0, which is very early cancer to stage 4, which is metastatic colorectal cancer.

Metastatic colorectal cancer is cancer that has spread. This means it has spread to regional or distant sites, such as other organs or lymph nodes.
According to the National Cancer Institute, although cancer can spread to any other part of the body, colorectal cancer most often metastasizes to the liver, lungs, or peritoneum.
Approximately 21% of people newly diagnosed with colorectal cancer have distant metastatic disease at the time of diagnosis.
Colorectal cancer that has spread to distant sites is rarely curable. Once the cancer has spread, it is very difficult to control.
However, there are treatments that can help stop or slow cancer growth and control symptoms. Continuous developments in colorectal cancer treatments have improved survival rates.

Colorectal cancer is more likely to cause symptoms in the later stages, when the cancer has grown or spread.
Symptoms of colorectal cancer include:
Change in bowel habits; such as having constipation, diarrhea, or narrow stools, lasting more than a few days. There is blood in the stool, which can make the stools chestnut or black. Bright red rectal bleeding. Feeling as if your bowels aren't empty after a bowel movement. Feeling of cramping in the abdomen or abdominal pain. Tired. Unexplained weight loss. Anemia . Symptoms of metastatic colorectal cancer depend on where the cancer has spread and the size of the metastatic tumor. Some symptoms may include:
Jaundice or abdominal swelling, when the cancer has spread to the liver. Shortness of breath, when the cancer has spread to the lungs. Bone pain and fractures, when the cancer has spread to the bone. Dizziness, headache, or convulsions when the cancer has spread to the brain.

Colorectal cancer usually begins as a tumor that develops in the inner lining of the rectum or colon. It grows and transforms slowly within a few years.
Once the cancer has grown, it can go deeper into the wall of your colon or rectum and continue to invade blood or lymph vessels. Cancer cells can spread into nearby lymph nodes or blood vessels and may also spread to other organs or tissues.
The most common places for colorectal cancer to metastasize are the liver, lungs, and peritoneum. However, cancer can also spread to other parts of the body, such as the bones and brain.

Some people have metastatic colorectal cancer at the time of first diagnosis. Many others find out their cancer has spread months or even years after their first diagnosis.
The main test used to diagnose colorectal cancer is colonoscopy, along with biopsies, other cell and tissue studies. Metastatic colorectal cancer is diagnosed using imaging tests to see if the cancer has spread. A biopsy may be done on a distant tumor to check if it is a metastatic tumor or another type of primary cancer. Imaging tests used to diagnose metastatic colorectal cancer include:
Computed tomography. A CT Scan is used to see if colorectal cancer has spread to the lymph nodes or other organs in your chest, abdomen, or pelvis. CT scans can also be used to guide biopsies to confirm metastases in organs, such as the liver. Supersonic . An abdominal ultrasound can be used to see if colorectal cancer has spread to the liver. Biopsy can also be done with ultrasound guidance, if needed. MRI scan. An MRI of the pelvis or abdomen can be used to see where the cancer has spread in the pelvis and if there are any lymph nodes involved. X-rays. A chest x-ray is often used to see if colorectal cancer has spread to the lungs. X-rays may also be used to check for bone metastases. PET/CT scan. PET scans are often used to check for metastases throughout the body, including the brain. It can also be used for staging and treatment planning; such as surgery, for metastatic tumors. A combined PET/CT scan may also be used.

Treatment for colorectal cancer depends on several factors, including how far it has spread and the size and location of the tumors. Your age, overall health, and potential side effects from cancer treatment are also considered.
Your doctor will work with you to determine the best treatment for your particular condition. Metastatic colorectal cancer is rarely curable. The goals of treatment are usually to prolong life and reduce or prevent symptoms. In rare cases, metastatic rectal cancer can be cured by surgically removing all of the tumor.
Most of the time, treatment for metastatic colorectal cancer is done with the hope of keeping the cancer under control for as long as possible. Each patient responds to treatment differently, so you may live longer than others or vice versa.
Surgery may be done to ease or prevent complications, such as a blockage of the colon. When only a few metastases are confined to the lungs or liver, surgery may be used to remove them; as well as the primary tumor, to try to improve survival.
Chemotherapy, radiation therapy, and targeted therapies can be used alone or in combination to shrink tumors, reduce symptoms, and prolong survival. In recent years, there have been several approved targeted therapies for metastatic colorectal cancer.
Your doctor may also prescribe medication to control pain, nausea, and other side effects of cancer or treatment.

Metastatic cancer, even when incurable, can sometimes be kept under control for months or years.
The development of colorectal cancer treatments in recent years has helped people live longer with the disease.
The most recent relative 5-year survival rate for distant metastatic colorectal cancer is 13.8%. This means that 13.8% of people with metastatic colorectal cancer are still alive 5 years after diagnosis.
Survival rates are estimates only and cannot predict individual outcomes. This number does not take into account many other important factors; such as a person's age or health problems, certain tumor markers, proteins or treatments used, and how a person responds to treatment.
Your doctor can help come up with this number based on your condition.
Colorectal cancer is completely curable if detected early, so screening for early detection of colorectal cancer is very important. When there are risk factors or suspicious symptoms, you should go to hospitals and specialized medical centers for screening to help detect colorectal cancer early.
Vinmec International General Hospital is a large hospital chain, the first general hospital in Vietnam to meet global medical standards. Currently, Vinmec is a leading medical facility in the field of colorectal cancer screening and detection.
Vinmec International General Hospital is one of the hospitals that ensures modern equipment, a team of doctors, good and experienced staff with leading professors and doctors at home and abroad. Preventive, advanced tests allow the implementation of the most advanced colorectal cancer screening techniques.