Treatment for Metastasized Colorectal Cancer

The liver is the most frequent site for metastasized colorectal cancers. Here, treatments may slow the spread of cancer and even prolong survival. Cure is very rare.

Surgery

When cancer has spread, surgery to remove or bypass obstructions in the intestine may be performed. In these circumstances, surgery is considered palliative in that it may improve symptoms but will not lead to cure. In rare cases, metastatic colon cancer may be cured with surgical removal of tumors in areas to which the cancer has spread, such as the liver, ovaries, and lung. The liver is the most common site of spread. Only selected patients may be eligible for such surgery, but in such patients five-year survival has been 25% and may be higher.

Chemotherapy

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Chemotherapy may be used to improve symptoms and possibly a prolong survival in metastasized colorectal cancers. A number of investigative agents are being tested. Physicians are testing chemotherapy administered directly into the liver--a treatment called intrahepatic arterial chemotherapy. It is possible to shrink swollen, painful livers this way, but to date studies are not reporting any survival advantages with this approach compared to chemotherapy delivered intravenously.

Other Techniques

Other investigative techniques used to destroy liver tumors include:

• Cryosurgery. This approach freezes the tumor or surrounding tissue.
• Embolization. Embolization employs a catheter to deliver agents into the liver that block blood vessels and therefore starve the tumor. Chemotherapy is often delivered with these agents.
• Radiation.

For end-stage cancer, hospice care is a compassionate option.