Certain Factors Affect Prognosis And Treatment Options
The prognosis and treatment options depend on the following:
- Thestage of the cancer .
- Whether the cancer has blocked or made a hole in the colon.
- Whether there are any cancer cells left after surgery.
- Whether the cancer has recurred.
- The patients general health.
The prognosis also depends on the blood levels of carcinoembryonic antigen before treatment begins. CEA is a substance in the blood that may be increased when cancer is present.
Treating Stage Iii Colon Cancer
Stage III colon cancers have spread to nearby lymph nodes, but they have not yet spread to other parts of the body.
Surgery to remove the section of the colon with the cancer along with nearby lymph nodes, followed by adjuvant chemo is the standard treatment for this stage.
For chemo, either the FOLFOX or CapeOx regimens are used most often, but some patients may get 5-FU with leucovorin or capecitabine alone based on their age and health needs.
For some advanced colon cancers that cannot be removed completely by surgery, neoadjuvant chemotherapy given along with radiation might be recommended to shrink the cancer so it can be removed later with surgery. For some advanced cancers that have been removed by surgery, but were found to be attached to a nearby organ or have positive margins , adjuvant radiation might be recommended. Radiation therapy and/or chemo may be options for people who arent healthy enough for surgery.
Is Stage 4 Cancer Terminal
Terminal cancer cannot be cured or treated. A person with terminal cancer is actively dying and will usually not live for more than a few months.
Stage 4 pancreatic cancer is not always called terminal. While the cancer is at an advance or late stage, some people do live longer than a few months with it.
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Who Is At Risk For Colon Cancer
Colorectal cancer can affect anyone, but people living with inflammatory bowel disease are at an increased risk compared to the general population.
The average age of a colorectal cancer diagnosis is in people aged 50 and over, with the risk increasing with age.
Risk factors include a family history of polyps and colon cancer, obesity, smoking, alcohol, sedentary behaviour and a diet high in processed and red meat.
“Ironically, a lot of the lifestyle factors are good for other things as well,” says Krzyzanowska. “Having a healthy diet, not smoking and having a good weight” can decrease your risk of the disease.
Can Cancer Spread While On Chemo
There are several options for colon cancer treatment, including surgery and chemotherapy. Surgery can shrink the tumor and may be recommended before or after chemotherapy. It can also be a helpful way to prolong a patients life. However, determining whether you are a candidate for surgery is complex. It will require the input of multiple doctors.
Chemotherapy is a type of treatment that kills cancer cells. While chemotherapy can help shrink the cancer tumor, there is always a possibility that it could spread. It is common for colorectal cancer to spread to distant parts of the body. Once it has spread to a distant site, it is known as metastasis. Most cancers that develop metastases will first appear in the lungs or liver, and then spread to other parts of the body.
Depending on the stage of the colon cancer, a doctor may prescribe chemotherapy with targeted drugs. These drugs work by interfering with the process by which cancer cells create proteins that blind immune system cells. Targeted drugs are usually reserved for advanced cancer patients.
What Can You Do To Improve Your Odds
The biggest change in the last five years has been the number of drugs approved to treat colon cancerand the wider use of targeted therapies, says Dr. Biller. Talk to your doctor about the entire range of treatment available to you . Dr. Biller also recommends that her patients get palliative care early to help manage the symptoms and side effects of treatment. One study found that palliative care decreased such symptoms as fatigue and pain.
Survival Rate in Stage 4: National Cancer Institute/Surveillance, Epidemiology, and End Results Program Colorectal CancerCancer Stat Facts. seer.cancer.gov/statfacts/html/colorect.html
EGRF Target Therapy Benefits:Annals of Oncology . Prognostic and predictive value of primary tumor side in patients with RAS wild-type metastatic colorectal cancer treated with chemotherapy and EGFR directed antibodies in six randomized trials. pubmed.ncbi.nlm.nih.gov/28407110/
Palliative Care and Colon Cancer: Annals of Surgical Oncology . Palliative Care and Symptom Burden in the Last Year of Life: A Population Based Study of Patients With Gastrointestinal Cancers. pubmed.ncbi.nlm.nih.gov/30969388/
Common Myths About Colon Cancer
We hear misconceptions about colon cancer every day. One of them is that women dont need to get colonoscopies.
Thats not true, and we have real-life proof. One of our most memorable patients was a woman in her 30s. She worked in marketing and was training for a marathon when she noticed some blood in her stool. She didnt think a whole lot about it, but a month later she did the right thing and got a colonoscopy.
Within days, she was diagnosed with stage 4 colon cancer. Her life was turned upside down. Using a common surgical procedure, we removed the cancer from her colon and part of her liver. Its been nearly 5 years now, and shes doing great.
As a medical community, we have a long way to go in educating people and correcting misconceptions about colon cancer. Here are some of the most common myths weve heard:
Myth: If I have colon cancer, Im going to need extensive treatment over a long period of time.
Fact: Getting any kind of cancer diagnosis is frightening, but a majority of patients diagnosed with colon cancer have a solvable problem. Many colon cancers can be treated with a relatively common surgical procedure that is performed using an incision no larger than 3 inches.
Myth: Most of the time, when you are diagnosed with colon cancer, it is already spreading to other parts of your body.
Myth: If my colon cancer has spread, I probably wont live very long. My cancer will never be cured.
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Patients Can Enter Clinical Trials Before During Or After Starting Their Cancer Treatment
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCIs clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Strategies To Improve Treatment
The major research focus in advanced colon cancer is the identification of additional cancer driving mutations as targets for precision cancer medicines and the development of immunotherapy treatment strategies.
Precision cancer medicine uses targeted drugs and immunotherapies engineered to directly attack colon cancer cells with specific abnormalities, leaving normal cells largely unharmed. Development of precision medicines are for the treatment of colon cancer is ongoing and these novel medicines are first utilized patients with recurrent cancers and once proven effective they become available through clinical trials for treatment of earlier stage disease. All patients need to make sure their cancer undergoes genomic profiling. This can also be accomplished with a tissue sample and in blood using a liquid biopsy if tissue is not available.
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What Does The Treatment Timeline For Stage 0 Colon Cancer Look Like
Including surgery and follow-up exams, Stage 0 colon cancer can usually be treated in one to three months. But your doctor may recommend more frequent colon cancer screenings like colonoscopies or stool tests. A personal history of colon cancer means youre at higher risk of another bout of the disease.
Phase Iii Trial Of Xl092 In Certain Colorectal Cancer Patients
A Phase III trial of a next-generation tyrosine kinase inhibitor, XL092 has been initiated in patients with mismatch repair-proficient , microsatellite stable metastatic colorectal cancer .
The STELLAR-303 trial will compare the combination of XL092 with Roche’s Tecentriq against Bayer’s Stivarga in about 600 patients with RAS wild-type or RAS-mutated advanced CRC without high microsatellite instability or mismatch repair deficiency.
New Approaches to Treating Liver Metastases:
Researchers continue to explore news ways to treat cancer that has spread to the liver. One approach that is being evaluated is radioembolization. This strategy uses radioactive microspheres . The small spheres are injected into vasculature of the liver, where they tend to get lodged in the vasculature responsible for providing blood and nourishment to the cancer cells. While lodged in place, the radioactive substance spontaneously emits radiation to the surrounding cancerous area while minimizing radiation exposure to the healthy portions of the liver. Researchers are also exploring alternatives to radiofrequency ablation for the destruction of liver tumors, as well as new approaches to delivering chemotherapy to the liver.
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Patients May Want To Think About Taking Part In A Clinical Trial
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today’s standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
A Stage 4 Cancer Chemotherapy Breakthrough
Many have been faced with the all-too-common dilemma that arises when the oncologist orders a standard regime of chemotherapy to treat their advanced or stage 4 cancers, even after chemotherapy had previously failed. Patients often feel that the course of treatment can be worse than the disease itself. Whats more, there is seldom time to seek other specialized treatment options or to make a truly informed decision. Feeling rushed will likely amplify stress for the mind and body already overwhelmed by circumstance.
So whats a person to do? Let us first identify some common failures in the Stage 4 Cancer treatment process. Then, together we can explore some new life-changing solutions made available through our decade-plus clinical experience working with the most difficult cancers.
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Questions About Advanced Colon Cancer Treatment
by Health Writer
Youve gotten your initial diagnosis, which already was a shock. Now your doctor has more potentially bad newsyour cancer has spread and you are among the 22% of patients who has stage 4, or advanced, colon cancer. Now what? Youll probably have a lot of questions about your treatment plan and what you can expect. Here are some reassuring answers.
Medications Commonly Used To Treat Recurrent Colon Cancer
Erbitux is a monoclonal antibody that works by binding to the epidermal growth factor receptor . EGFR is involved in cellular growth and replication, and by targeting EGFR, the spread of cancer can be reduced or delayed.
Cyramzaâ¢ is as a monoclonal antibody that works by blocking the growth of new blood vessels to the cancer, essentially starving it of nutrients.
VectibixÂ® is a monoclonal antibody targeted against the EGFR pathway. Vectibix appears to benefit only those patients whose cancers do not contain a mutation in a gene known as KRAS. KRAS mutations occur in an estimated 40-50% of metastatic colorectal cancers and can be identified by testing a sample of tumor tissue.
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Chemotherapy Is Only 2% Effective In Late Stage Cancers
Many late stage cancer patients have endured unforgiving chemo treatment regimens only to realize minimal benefits, or worse, to discover their cancer was completely unresponsive. When accepting new treatments, most patients are not aware that chemotherapy is just 2 percent effective in late stage cancers after a five year period.
Despite the National Cancer Institutes forty years of scientific research , stage 3 and 4 chemotherapy-driven cancer treatments have not progressed a whole lot. In fact, the treatments typically do not work.
In his book An Anatomy of Failure: A Blueprint for Future Years, Dr. Guy B. Faguet* suggests that chemotherapy has not been shown to assist or advance survival beyond five years in most adults who suffer with advanced and late stage cancers. The MD and Professor in the Hematology and Oncology Division at the Medical College of Georgia did a comprehensive job of exploring the potency and effectiveness of conventional chemotherapy. The doctor asserts that beyond decided proficiencies in treating a few types of cancers, like acute lymphocytic leukemia in youngsters, or choriocarcinoma, germ cell growths found in youths, chemo has a disappointing track-record.
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What Are The Warning Signs And Symptoms Of Colon Cancer
Colorectal cancer may not present any significant signs or symptoms in its early stages, making it all the more important to stay up-to-date on your colon health and get screened regularly.
According to the American Cancer Society, a polyp can take as long as 10 to 15 years to develop into cancer. Therefore, symptoms often only start appearing once a tumour grows and affects the surrounding organs and tissues. The early signs of colorectal cancer are often similar to other health conditions, including anemia and irritable bowel syndrome.
Dr. Monika Krzyzanowska, a medical oncologist at the Princess Margaret Cancer Centre, says one of the early signs of the disease is a change in bowel habits.
” may not be going as often as they usually do,” she tells Yahoo Canada over the phone. “The calibre of your stool may change. For example, it can become thinner or more narrow.”
Krzyzanowska notes that abdominal pain, bleeding and unexplained weight loss are causes for concern, alongside iron-deficiency anemia.
“One of the things people may not know is iron-deficiency anemia,” she says. “They may be feeling tired, go see their family doctor, and are found to be anemic. This can sometimes be an initial presentation of colon cancer.”
Other signs or symptoms of colorectal cancer may include:
Blood in the stool
Pain or discomfort in the rectum
Bleeding from the rectum
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Questions You May Want To Ask Your Doctor Or Nurse
- Do I have any more treatment options?
- How long do I have left to live?
- How accurate is my prognosis?
- Should I get a second opinion?
- I dont want to know my prognosis, but can you tell me how my cancer will change?
- What symptoms will I have? How can symptoms be managed?
- What difference will it make to how well I feel if I decide to have chemotherapy? What happens if I dont have chemotherapy?
- What are the benefits of having treatment?
- Are there any risks from treatment?
- If I dont have chemotherapy, are there other treatment options?
- Is there anything I can do to help me live longer?
- Can you speak to my family about my future if I give my permission?
- If I dont want to know my prognosis but my family do, can you speak to them in confidence, if I give my permission?
How Colon Cancer Is Staged
If youve been diagnosed with colon cancer , one of the first things your doctor will want to determine is the stage of your cancer.
The stage is used to represent the extent of the cancer and how far its spread. Staging colon cancer is essential to determining the best treatment approach.
Colon cancer is typically staged based on the TNM staging system, which was established by the Union for International Cancer Control and later adopted by the American Joint Committee on Cancer.
The system considers the following factors:
- Primary tumor . T refers to how large the original tumor is and whether cancer has grown into the wall of the colon or spread to adjacent organs or structures.
- Regional lymph nodes . N refers to whether cancer cells have spread to nearby lymph nodes.
- Distant metastases . M refers to whether cancer has metastasized from the colon to other parts of the body, like the lungs or liver.
In some cases, theres not enough information to assess the tumor or nodes. Instead of including a number , the cancer category will be TX or NX.
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There Are Three Ways That Cancer Spreads In The Body
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
How Do Targeted Therapies Work
You get both types via IV infusions. Lets start with the anti-angiogenesis therapyangiogenesis means the development of new blood vessels, and these drugs prevent that from happening. Stopping blood vessel growth is important for cancer treatment because tumors need more blood vessel growth than other parts of the body, says Dr. Biller.
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