Stage 4 Colon Cancer: Treatment and Outlook

Stage 4 colon cancer is considered advanced: cancer has spread beyond your colon to distant organs. Treatment may involve a combination of surgery, chemotherapy, targeted therapy, or ablation.

According to the American Cancer Society (ACS) , an estimated 13% of people in the United States live at least 5 years after receiving a stage 4 colon cancer diagnosis compared with people in the general population who don’t have colon cancer.

The goal of treating stage 4 colon cancer is to prolong and improve your quality of life. Very rarely can treatment cure stage 4 colon cancer.

The treatments used depends on the location, grade, and size of the tumors that have spread beyond your colon. Doctors may recommend a combination of surgery, chemotherapy, targeted therapy , or ablation to remove cancerous tumors. Palliative care may also be an option.

In this article, we take a closer look at how stage 4 colon cancer is classified, along with your treatment options and outlook.

Facts about colon cancer

• An estimated 106,970 people will receive a diagnosis of colon cancer in the United States in 2023.
• Your risk of developing colon cancer gets higher as you get older. Other risk factors include eating a low-fiber, high-fat diet, drinking alcohol, and smoking.
• The median age to receive a diagnosis of colon cancer is 68 years old in people assigned male at birth and 72 years old in people assigned female at birth.
• In most cases , colon cancers are slow growing and develop over many years. People often receive the diagnosis at the later stages when symptoms present.
• Regular screening for colon cancer is an excellent way to find colon cancer early. The best time to start screening is when you’re 45 years old.

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In stage 4 colon cancer, the cancer has spread from your colon to other areas of your body through your lymphatic and blood circulatory systems. Doctors call this spread “metastasis.” The severity of this stage is dependent on where the cancer has metastasized.

Doctors also grade cancers to help determine your treatment and outlook.

A grade is determined by what the cancer cells look like under a microscope. It’s a way of classifying how aggressive a cancer may be. For example:

• Grade 1 (low grade): The cancer cells are well differentiated, or slow growing.
• Grade 2 (intermediate grade): The cancer cells are moderately differentiated, or intermediate growing.
• Grade 3 (high grade): The cancer cells are poorly differentiated, or fast growing.

Is stage 4 colon cancer curable?

Treatment for stage 4 colon cancer focuses on prolonging and and improving your quality of life. The goal is usually not to cure stage 4 colon cancer, except in very, very rare instances. It’s important to have an open discussion with a doctor to better understand your cancer and the goals of your treatment.

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Doctors who specialize in cancer treatments are called oncologists. They’ll work with you to create a treatment plan that works best for you.

The type of treatment your oncologist may recommend depends on the location, grade, and size of the tumors inside and outside of your colon. If the areas of cancer spread are small, surgery can help you to live longer and may improve your quality of life.

Surgery

Typically, surgery for stage 4 colon cancer involves the removal of the sites where the cancer has spread. This is often your colon, your lymph nodes, and areas of your liver.

If the cancer is blocking your colon , a surgeon may remove a section of the organ in order to keep your colon open. A doctor may also perform a procedure called a colostomy to redirect one end of your intestine through an incision in your abdominal wall to create a stoma. A stoma is an opening in your skin where a pouch is attached for collecting feces.

Chemotherapy before or after surgery

A doctor may suggest chemotherapy after surgery. This is called adjuvant chemotherapy. Adjuvant therapy helps lower the chance that the cancer will return and potentially improves the outcome of your surgery. Cancer cells can sometimes be left behind after surgery, and adjuvant therapy helps remove them from your bloodstream or lymphatic system.

If the cancer spread is large, or there are simply too many sites, doctors may suggest chemotherapy before surgery. This is called neoadjuvant chemotherapy. If the tumors respond to chemotherapy and shrink in size, then surgery may be able to remove them.

Ablation

If stage 4 colon cancer has spread to your liver, then ablation , a process that destroys cancer cells in the liver, may be effective. This is a nonsurgical procedure that uses an ultrasound scan to guide the process.

Targeted therapy

An oncologist may recommend targeted therapy as a way to control the growth of your cancer. As with chemotherapy, these targeted medications enter through your bloodstream. They can reach almost all areas of your body. This makes them useful for cancers that have spread to distant regions.

Targeted therapy can be used alongside chemotherapy or by itself if the chemotherapy isn’t working.