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November 20, 2020 If you or a loved one is dealing with colorectal cancer that has spread to the liver (colorectal liver metastasis), here’s some hopeful news: although the condition has long been difficult to treat, recent advances are making a big impact. Unlike primary liver cancer, which begins inside the liver, colorectal liver metastases are cancers that have spread to the liver from the colon or rectum. It’s most common in cases of late-stage colorectal cancer or colorectal cancer that recurs. Regardless of stage, stopping colorectal liver metastasis is challenging. “A surgical evaluation is important early on in treatment,” said Jason A. Castellanos, MD, MS, a surgical oncologist at Fox Chase Cancer Center. “While chemotherapy plays an important role, surgery is also an essential treatment to consider when evaluating patients with these types of tumors.” But not every patient is a candidate for surgery when they’re first diagnosed with colorectal liver metastasis. And surgery, according to Castellanos, can pose significant risks. That’s why experts at cancer centers like Fox Chase are leading the way in finding new approaches to treating cancers that have spread to the liver from the colon or rectum and making them more amenable to surgery. “Anywhere from 25 to 40 percent of cancer patients with colorectal liver metastases that can be removed have the potential to live at least 10 more years, depending on multiple factors,” Castellanos said. “And, there have been a lot of technical innovations in the last 20 years that have made treatment for these metastases much safer.” These innovations include:
In cases where a tumor is too large to be safely removed right away, treatments like hepatic arterial infusion chemotherapy can shrink the tumor enough to make a patient eligible for surgery. “We place a catheter into the artery and attach a subcutaneous pump in the abdomen so patients can get chemotherapy continuously to try to shrink the tumor,” Castellanos said. “It can help us get to a point where less liver needs to be removed during surgery.” External beam or other radiation techniques may also be used to treat tumors that can’t be removed surgically. Expertise MattersTo gain access to the latest techniques and treatment options, it’s important to be seen at a designated cancer center with experienced cancer specialists. “We know that patients treated at centers not specialized in treating colorectal liver metastases aren’t always able to have surgery,” Castellanos said. “Coming to a center like Fox Chase allows for multidisciplinary opinions, making it more likely that patients will receive optimal treatment.” Stage 4 bowel (colon and rectal) cancer means the cancer has spread to other parts of the body, such as the liver or lungs. It's also called advanced bowel cancer. Stage 4 is divided into 3 stages - 4A, 4B and 4C. Stage 4A means that the cancer has spread to 1 distant site or organ, for example the liver, but it hasn’t spread to the tissue lining your tummy (peritoneum). The cancer spreads through the lymphatic system or the bloodstream. Stage 4B means the cancer has spread to 2 or more distant organs, but it hasn’t spread to the tissue lining your tummy (peritoneum). Stage 4C means the cancer may have spread to distant organs and it has spread to the lining of your tummy (peritoneum). TNM stagesTNM stands for tumour, node and metastasis. In the TNM staging system, stage 4A is the same as:
Stage 4B is the same as:
Stage 4C is the same as:
Treatment for stage 4 large bowel (colon) cancerYour doctor might recommend:
Treatment for stage 4 cancer of the back passage (rectal)Your doctor might recommend:
Other stagesWhat is the survival rate of stage 4 colon cancer that has spread to the liver?Colon cancer most often spreads to the liver, but it may also reach the lungs, the lymph nodes, or the lining of the abdominal cavity. The American Cancer Society (ACS) note that the 5-year relative survival rate for people with stage 4 colon cancer that has spread is 14%.
Can you survive bowel cancer that has spread to the liver?Richard Burkhart, a Johns Hopkins cancer surgeon and researcher, advancements in the treatment of liver tumors caused by colon cancer have improved survival rates drastically. In fact, 40-60 percent of patients treated for isolated colon cancer liver metastasis are still alive five years after treatment.
What happens if colon cancer spreads to the liver?When colon cancer works its way into the liver, you may not get any clear signs that it's happened. But if you do, the symptoms can range from pain and itching to tiredness and hiccups. Even if they can't cure the cancer, treatments like surgery, radiation, and chemotherapy can often give you relief.
What is the prognosis for colon cancer metastasis to the liver?“Anywhere from 25 to 40 percent of cancer patients with colorectal liver metastases that can be removed have the potential to live at least 10 more years, depending on multiple factors,” Castellanos said.
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Colon cancer stage 4 spread to liver
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