Advanced Colorectal Cancer

Treatment Options by Stage

Choosing the best treatment plan for advanced colorectal cancer involves considering the results of staging procedures and other tests. And even after a plan has been established, it may change based on further testing. The options listed here for the advanced stages of colorectal cancer provide basic information about how your cancer may be treated. Many other details are involved, however, so make sure you discuss them with your treatment team.

Stage III

Colon cancer

Treatment usually involves:

  • Surgery to remove the tumor and lymph nodes (a colostomy is usually unnecessary)
  • Adjuvant chemotherapy
  • Palliative care to manage symptoms and treatment-related side effects

Clinical trials are also an option. Radiation therapy is only used in special circumstances.

Rectal cancer

Treatment usually involves:

  • Neoadjuvant chemoradiation therapy
  • Surgery to remove the tumor and lymph nodes (a colostomy may be necessary)
  • Adjuvant chemotherapy
  • Palliative care to manage symptoms and treatment-related side effects

Clinical trials are also an option.

Stage IV

Colon cancer

Treatment usually involves:

  • Neoadjuvant chemotherapy and/or targeted therapy (for select patients who might be eligible for surgical removal of metastatic disease, such as in the liver or lung)
  • Surgery for cure and/or to relieve symptoms (in combination with other treatments for select patients with metastatic disease)
  • Adjuvant chemotherapy after surgical resection of metastatic disease
  • Palliative care to manage symptoms and treatment-related side effects
  • Hospice care, when appropriate

Clinical trials are also an option. Radiation therapy is only used in special circumstances.

Rectal cancer

Treatment usually involves:

  • Neoadjuvant chemotherapy (usually given with radiation) and/or targeted therapy
  • Neoadjuvant radiation therapy with the intent to cure (given in combination with chemotherapy)
  • Surgery for cure and/or to relieve symptoms (in combination with other treatments for metastatic disease)
  • Adjuvant chemotherapy
  • Palliative radiation therapy to relieve symptoms
  • Palliative care to manage symptoms and treatment-related side effects
  • Hospice care, when appropriate

Clinical trials are also an option.

Terminal colorectal cancer

Recovery from cancer is always the goal, but it is not always possible. In these instances, the cancer is called terminal and the emphasis shifts from intending to cure, to making sure the person is free from pain and as physically comfortable as possible. The type of care given toward the end of someone’s life is called hospice care, and it can often be given at home, in the hospital or in a hospice environment—wherever the patient is most comfortable.

A terminal colorectal cancer diagnosis carries significant stress and can be difficult to discuss. However, open and honest conversations with the members of your health care team about your preferences and concerns are extremely important. There are several options and resources that they can make available to you if they know what you are looking for.

 

Recurrent colorectal cancer

Remission occurs when cancer can no longer be detected in the body and there are no longer any symptoms. A remission can be temporary or permanent. If the cancer comes back, it is called recurrent cancer. The cancer may return in the original location in the colon or rectum (local recurrence), near the original location (regional recurrence) or far away from the original location (distant recurrence). If you experience recurrent colorectal cancer, talk to your doctor about your treatment options. Often, the treatment plan for recurrent disease will be similar to the treatment plan for Stage IV disease.

 

Additional Resources

 

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