Colon cancer is the 3rd most commonly identified cancer in both males as well as females in the world. In India, 4.4 people per lac get colon cancer and thus almost 60,000 people get colon cancer each year or 157 new colon cancers are diagnosed every day. Overall 5 years survival rates are 14 to 19%; however 5 year survival rates for patients with stage 4 colon cancer that metastasize to liver and had removal of liver metastases at the same time as colon surgery improved up to 70%, which is a huge survival advantage.
Stage 4 colon cancer is late-stage cancer in which the disease has actually spread to other tissues or body organs in the body and also is, as a result, harder to treat. Treatment may just be partly successful, and also cancer may be more likely to return after treatment. Colon cancer usually infects the liver, however it can also infect other locations like the lungs, brain, peritoneum, or to distant lymph nodes.
Surgery followed by chemotherapy for stage 4 colon cancer
If there are only a couple of small locations of cancer spread (metastases) in the liver or lungs and they can be removed along with the colon cancer, surgery will give the best results. Colon surgery along with removal of a part of the liver or lung containing the cancer procedure may give better results and helps one live longer. Surgery will be followed by appropriate chemotherapy.
It’s very crucial to understand the goal of the surgery ─ whether it’s to try to heal the cancer or to avoid or alleviate signs and symptoms of the cancer. This aspect has to be clearly understood, if one has stage 4 colon cancer.
Chemotherapy for stage 4 colon cancer followed by surgery and further chemotherapy
If the metastases cannot be eliminated because they’re too big or there are as well several of them, chemotherapy may be given before surgery (neoadjuvant chemo). Chemo may be offered once more after surgical treatment. A lot of patients respond very well to this combination management plan. At times, the secondary tumours will disappear outright and thus the surgical procedure does become simpler and yields better results.
Chemotherapy for colon cancer
If the cancer spread excessive and widespread, one will not attempt to treat it with surgical procedure; chemotherapy is the main therapy in these situations. Surgical procedure might still be required if the cancer is blocking the colon or is most likely to do so; this is called colon obstruction or large intestinal obstruction. Chemotherapy remains the backbone of management in these situations.
Stage 4 colon cancer with intestinal obstruction
Sometimes, a surgical procedure can be avoided by putting a stent (a hollow steel tube) right into the colon where the cancer is, during a colonoscopy, to keep it open. Otherwise, operations such as a colectomy or diverting colostomy (cutting the colon above the level of the cancer, bringing it out and affixing the end to an opening in the skin on the belly to enable waste to be collected in a bag). This is called a colostomy or an ileostomy; these are also called diversion stomas.
Chemotherapy or targeted therapy or both for stage 4 colon cancer
Most people with phase IV cancer cells will certainly obtain chemo and/or targeted therapies to regulate the cancer cells. A few of the most typically regimens include:
- FOLFOX: leucovorin, 5-FU, and also oxaliplatin.
- FOLFIRI: leucovorin, 5-FU, as well as irinotecan.
- CAPEOX or CAPOX: capecitabine (Xeloda) and oxaliplatin.
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan.
- One of the above mixes plus either a drug that targets VEGF, (bevacizumab [Avastin], ziv-aflibercept, or ramucirumab, or a drug that targets EGFR (cetuximab [Erbitux] or panitumumab.
- 5-FU and leucovorin, with or without a targeted medication.
- Capecitabine, with or without a targeted medicine.
- Irinotecan, with or without a targeted medicine.
- Cetuximab alone.
- Panitumumab alone.
- Regorafenib alone.
The option of regimen to be used depends upon a number of aspects, including previous therapies you’ve had and also your overall wellness. At times one has to toggle these combinations depending upon the effectiveness of these medications.
Radiotherapy for stage 4 colon cancer
Radiation treatment can also be made use of to relieve signs and symptoms in the colon from the cancer such as pain. It could additionally be used to treat locations of spread such as in the lungs or bone. It may reduce tumours for a while, but it’s not most likely to treat the cancer.
Outcomes after treatment of stage 4 colon cancer
Thus, we can safely say that the 5 year survival rates for colon cancer range between 14% to up to 70%. The success of specific treatment approaches may differ among individuals, with treatments successful for some individuals having little effect in others.
Additionally, specialists base these statistics on previous cases. As treatments often tend to get better gradually, survival rates may be more reliable and better as improved treatments become available.
Specific factors can likewise play a significant function in a person’s outcome. For instance, the age as well as general wellness of a person might influence their responsiveness to therapy.
Recap for Stage 4 Colon Cancer
Stage 4 colon cancer is a late-stage cancer.
The 5-year relative survival rate for stage 4 colon cancer that is spread out to various other parts of the body is about 14%.
However, 5 year survival rate is almost 70%, where the tumour spread is less and can be removed along with colon cancer.
Colon cancer responds well to combination chemotherapy.
Stage 4 colon cancer disease can be kept in abeyance for years with various modalities.