The body’s digestive system processes the food and liquids that we consume and prepares them for elimination from the body as waste. The large intestine, or colon, is part of the digestive system, along with the small intestine, esophagus, stomach, rectum (the last portion of the colon), and anus (the opening at the end of the rectum through which wastes passes). The colon is an approximately 5 to 6-foot long tube that connects the small intestine to the rectum.
Systemic colorectal cancer symptoms are those that affect your entire body. If you experience any of these for any length of time, even. This is the most critical factor. According to the National Cancer Institute*, survival for Stage I colon or rectal cancer is about 93 percent. Survival for Stage II is between 72 and 85 percent and for Stage III, 44 and 83 percent. Chemotherapy may improve prognosis for Stage III cancer. Stage IV cancer has a poor prognosis; about 8 percent are alive at five years.
Early colorectal cancer relapse symptoms may not always be apparent. Regular screenings are recommended as part of a continued health plan for patients who have been treated for colorectal cancer, because symptoms often do not develop until the disease has progressed.
People with colon cancers that have not spread to distant sites usually have surgery as the main or first treatment. Adjuvant (additional) chemotherapy may also be used. Most adjuvant treatment is given for about 6 months.
Colon Cancer Stages
The stage of a cancer describes the extent of the cancer in the body. It helps determine how serious the cancer is and how best to treat it. The stage is one of the most important factors in deciding how to treat the cancer and determining how successful treatment might be. One of the biggest concerns about a cancer diagnosis is whether the cancer has spread (metastasized) beyond its original location. To determine this, the doctor assigns a number (I through IV) to the diagnosis. The higher the number, the more the cancer has spread throughout the body. This is called “staging.”
The stages of colorectal cancer include the following:
• Stage I: The cancer has penetrated into the middle layers of the colon wall but not through it.
• Stage II: The colorectal cancer has penetrated through the muscle wall of the colon.
• Stage III: The cancer has moved to lymph nodes ear the colon and rectum.
• Stage IV: The cancer has spread to lymph nodes and to other sites in the body, such as the liver, lungs or lining of the abdomen (peritoneum).
Colon Cancer Stage 4
Stage IV is the most advanced stage of colorectal cancer. If you have been diagnosed with stage IV colorectal cancer, it means that the cancer has metastasized to distant sites, such as the liver or lungs. The cancer may or may not have grown through the wall of the colon or rectum, and lymph nodes may or may not have been affected. Stage IV colorectal cancer is further divided into two categories, depending on whether or not the metastasis has affected more than one organ. The original tumor can be of any size and lymph nodes may or may not be involved, but if the cancer has spread to one different organ it is considered stage IVA, while more than one organ would be defined as stage IVB. Stage IV colorectal cancer can be defined by any T or N category, with the only difference stemming from whether the M1 or M2 assignment is more appropriate.
Stage 4 Colon Cancer Life Expectancy
Colon cancers that have spread to other parts of the body are often harder to treat and tend to have a poorer outlook. Metastatic, or stage IV colon cancers, have a 5-year relative survival rate of about 11%. Still, there are often many treatment options available for people with this stage of cancer.
Stage 4 Colon Cancer Treatment
Resection and anastomosis, removal of parts of other organs to which the cancer has spread, radiation and standard chemotherapy, clinical trials of chemotherapy or experiment biologic therapy. The surgical procedures for colon cancer include the following:
- Polypectomy: polyps are removed during a colonoscopy.
- Local excision: This procedure is performed when the cancer is in an early stage. It does not require major abdominal surgery; instead, the cancer is removed through the anus.
- Resection: total removal of parts of the colon and surrounding tissue which requires a major surgery.
Other treatment options include:
- Laparoscopic Surgery
- Radiation Therapy
Most patients with stage IV cancer will get chemo and/or targeted therapies to control the cancer. Some of the most commonly used regimens include:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CapeOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
- One of the above combinations plus either a drug that targets VEGF (bevacizumab [Avastin], ziv-aflibercept [Zaltrap], or ramucirumab [Cyramza]), or a drug that targets EGFR (cetuximab [Erbitux] or panitumumab [Vectibix])
- 5-FU and leucovorin, with or without a targeted drug
- Capecitabine, with or without a targeted drug
- Irinotecan, with or without a targeted drug
- Cetuximab alone
- Panitumumab alone
- Regorafenib (Stivarga) alone
- Trifluridine and tipiracil (Lonsurf)