Colon cancer stage 4: life expectancy and treatment methods

Stage IV colorectal cancer is a severe form of pathology in which a malignant tumor literally grows into the tissue of the intestine and surrounding organs, and also gives multiple metastases.

The disease is very difficult to treat, and the prognosis is often unfavorable. Remission is incredibly difficult to achieve, but modern methods of therapy can significantly alleviate the patient’s condition and prolong his life.

As a rule, a colorectal neoplasm affects not only the intestine itself, but also metastasizes to distant organs. Most often, secondary lesions develop in the liver, peritoneum, lungs, and bones.

The primary tumor is detected by colonoscopy. This happens as follows: a specialist inserts a colonoscope (a thin flexible tube with a video camera and light) into the colon, examines the affected area, and, if necessary, takes samples of tumor cells for histological and cytological examination (biopsy).

To detect metastatic foci, the gold standard diagnostic methods are used:

• Classic radiography, thanks to which it is possible to identify lesions in the lungs.
• Ultrasound, which detects metastatic areas in the liver, peritoneum, and pelvic organs.
• CT, PET-CT and MRI used to examine the human body, including the lungs, abdominal organs, bones, etc.
• Colon cancer, life expectancy (approximate) and form of therapeutic effect are determined based on research results. Depending on the number of metastases, oncologists distinguish the following substages:
• IVA: a secondary lesion is found in only one organ.
• IVB: 2 or more organs have undergone metastasis.
• IVC: peritoneal carcinomatosis develops, that is, the entire surface of the serous membrane of the peritoneum is damaged by metastases.

The symptoms of the disease are determined by the characteristics of the tumor process. The first and second stages, as a rule, are practically asymptomatic, or the manifestations are similar to those of completely other diseases. This is why many patients turn to specialists too late, when the process reaches a late stage.

We list the most obvious signs of stage 4 intestinal cancer:

• Weakness, lethargy, headaches.
• Fatigue, loss of appetite and body weight.
• Blood in the stool.
• Anemia as a result of internal bleeding, as well as accompanying symptoms: pallor, dizziness.
• Change in stool shape due to narrowing of the intestinal lumen.
• Constant disorders and, as a result, constipation, diarrhea, bloating.
• Painful sensations.
• Nausea, vomiting.

The process of metastasis significantly increases the number of symptoms of the disease. Thus, when secondary lesions form in the lungs, the patient experiences chest pain, shortness of breath, a chronic cough mixed with blood clots, and difficulty breathing. If the liver is affected by metastases, its functions are impaired. Externally, this manifests itself in the form of jaundice, swelling of the lower extremities, pain in the upper abdomen, as well as ascites or abdominal dropsy.

In women with rectal cancer, the disease can metastasize to the pelvic organs. According to studies, a quarter of patients have ovarian metastases, which negatively affects the general well-being of patients.

Colorectal cancer can also metastasize to bone. Therefore, patients are often bothered by constant pain in those areas where secondary lesions are localized: in the back or neck, arms or legs. In addition to pain, there is another serious danger - due to the disease, bones become fragile and even small mechanical loads lead to fractures.

In order for the therapy to be as effective as possible, the oncologist draws up a treatment plan for each patient individually, taking into account many different factors, such as

• concomitant diseases and medications taken;
• current health status;
• possible side effects;
• diet, psychological state of the patient;
• availability of social support, etc.

As a rule, if the development of the disease has reached multiple metastases, then radical therapy is no longer offered. Stage 4 colon cancer, no matter how hard you try, cannot be completely removed. Very rarely, single metastases can be removed surgically and ensure remission. Therefore, the oncologist focuses on relieving pain and ensuring the maximum possible functionality of the patient’s gastrointestinal tract. That is, so-called palliative therapy is prescribed, thanks to which the patient’s quality of life improves. For example, according to the surgeon's indications:

• removes a section of the intestine blocked by a tumor;
• installs a metal or polymer stent to expand the lumen;
• performs a colostomy, in which a specialist sutures a section of intestine to the wall of the abdominal cavity and creates an opening through which feces are removed;
• performs radiofrequency or cryogenic ablation procedures to heat or freeze tumor cells. The techniques avoid the removal of parenchymal or lung tissue.
• Side effects of surgical intervention: incomplete anamostosis and, as a consequence, the development of peritonitis, possible formation of adhesions, disorders, etc.

For the treatment of colorectal oncology, specialists also prescribe classical methods of evidence-based medicine:
Radiation therapy. High-energy X-ray radiation destroys malignant tumors and prevents the recurrence of tumors in the intestine. Performed after or instead of surgery according to indications. Side effects are possible (fatigue, dyspepsia, internal bleeding) and disappear after completion of the course.

Drug treatment: chemotherapy, targeted and immunological therapy. Depending on the localization of tumor foci and acceptable radical treatment, this can be adjuvant therapy (postoperative to reduce the risk of relapse) and neoadjuvant (preoperative to reduce the volume of the lesion and slow down tumor growth). The specialist prescribes one or a combination of drugs that stimulate the body’s immune response, destroy pathology, prevent the appearance of new vessels that feed the tumor, etc. Side effects of drug treatment: allergic reactions, febrile conditions, neuropathy, the appearance of ulcers on the oral mucosa, alopecia, muscle pain, dyspepsia, damage to internal organs (pancreas, liver), etc.

To increase the effectiveness of treatment and achieve remission, techniques can be combined or supplemented with painkillers.

Unfortunately, the doctor cannot guarantee that the current oncology treatment plan will give the desired result and justify the life prognosis. Stage 4 intestinal cancer in a terminal or progressive stage is a psychologically difficult diagnosis, so the patient needs the support of loved ones, as well as highly specialized specialists.
In addition, various complications are possible:

• Formation of areas with intestinal obstruction. Eliminated by stenting or resection of the blocked area followed by colostomy.
• Development of ascites. To remove accumulated fluid in the peritoneum, simple surgical procedures are performed. For example, a puncture is performed and a drainage tube is implanted.
• Development of obstructive jaundice due to liver dysfunction. In this case, operations to stent the bile ducts and other similar manipulations are performed.
• The spread of a cancerous tumor along the surface of the serous membrane in the peritoneum is carcinomatosis. For treatment, specialists use various modern techniques, for example, hyperthermic chemotherapy (HIPEC).

The prognosis for patients with colorectal oncology, as a rule, cannot be called optimistic. Toxic lesions “hit” not only the organs of the gastrointestinal tract the hardest, but also affect other parts of the body, including the brain and heart. According to statistics, after 5 years after treatment, only 13% of patients with colon tumors survive and about 17% with tumors in the rectum survive.

The numbers are not very encouraging, but this is not a reason to give up. First of all, you need to remember that any statistics are averaged data. And doctors know patients with tumors who live and feel great for decades.

Stage 4 colorectal cancer is considered a serious pathology. It is almost impossible to cure in advanced conditions. To have a chance of recovery and a normal life, you need two components: timely treatment and selection of the correct therapy method.