Colon and Rectal Cancer, Metastatic (Spreading)

What is metastatic colon and rectal cancer?

A metastasis is the spread of cancer cells from one part of the body to another. In metastatic colon and rectal cancer (colorectal cancer), cancer cells from the colon or rectum begin to grow in another part of the body, usually the liver or lungs.

How does it occur?

A metastasis occurs when cells from a cancer break off from the original tumor and travel through the lymph system or the bloodstream to another location. The exact reason cancer cells spread is not known.

What are the symptoms?

Some possible symptoms of the recurrence or spread of colorectal cancer include:

• abdominal pain
• loss of appetite
• fatigue
• weight loss
• pelvic or rectal pain.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and examine you. In addition, you will have the following tests:

• blood tests
• bone X-rays (if you have bone pain)
• CT scan of your abdomen and pelvis
• chest X-ray.

Other tests you may have are:

• colonoscopy
• barium X-ray of the lower bowel.

A CT scan uses X-rays in a way that gives more detailed information than plain X-rays, especially about tissues that are not bone.

A colonoscopy is a procedure in which your healthcare provider inserts a slim, flexible tube into the rectum to see the inside of the rectum and all of the colon. Your provider will take a sample, or biopsy, of any abnormal tissue to examine for cancer cells.

A barium X-ray is a procedure in which barium is put into your rectum as an enema. After the barium enema, a technologist takes X-ray pictures as the barium moves through rectum and colon. Your provider will use the X-rays to look for abnormal shapes, narrowing, or blockage in the colon.

What is the treatment?

The treatment depends on where the cancer has spread. Development of more cancer in the colon may require more surgery. Spread to the liver or lungs is usually treated with chemotherapy (anti-cancer drugs). If the cancer has spread to the bone, radiation treatments may lessen pain and prevent further spread. Sometimes surgery is done to remove cancer that has spread to the liver, or (rarely) to the lungs.

How long will the effects last?

Metastatic colorectal cancer can usually be controlled only for a limited time, but sometimes it can be controlled for years. Talk to your healthcare provider about the expected course of your disease.

How can I take care of myself?

After you determine with your healthcare provider and family the treatment you prefer at this stage, follow the plan and keep your appointments. If you seek help outside the medical community, keep your provider informed about other drugs or treatments you are using to avoid side effects or interactions with your medical treatment. In addition:

• Learn relaxation and meditation techniques to help control fear, anxiety, and stress.
• Get plenty of rest.
• Eat healthy meals.

It may be useful to see a counselor to help you deal with your feelings and your particular situation.

How can help prevent metastatic colon and rectal cancer?

After you are first diagnosed with colorectal cancer, follow your treatment and follow-up plans carefully. This may help avoid the spread of cancer or delay metastasis as long as possible. See your healthcare provider right away if any signs or symptoms of cancer come back.