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, such as the lungs, liver, bones, or lymph nodes.

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 cause of the spread of cancer cells is unknown.

What are the symptoms?

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

• abdominal pain

• blood in the stool

• bone pain

• urinary tract problems (pain or increased frequency of urination).

How is it diagnosed?

To diagnose metastasis, your doctor reviews your symptoms and examines you. In addition, your doctor may order the following tests:

• blood tests that check liver function

• chest x-rays

• bone x-rays (if you have bone pain)

• hemoglobin test or complete blood count

• CT scans

• bone or liver scans

• sigmoidoscopy or colonoscopy

• barium x-ray.

A CT scan uses x-rays in a way that gives more detailed information than plain x-rays, especially about tissues other than bone.

A sigmoidoscopy or colonoscopy is a procedure in which the doctor inserts a slim, flexible tube into the rectum to see the inside of the colon. The doctor may take a sample, or biopsy, of any abnormal tissue to examine for cancer cells.

A barium x-ray is a procedure in which you either swallow a liquid containing barium or have a barium enema. (During an enema, liquid barium flows through the rectum into your lower bowel.) After the barium swallow or enema, a technician takes x-ray pictures as the barium moves through your colon. Your doctor will use the x-rays to look for abnormal shapes, narrowings, or blockages 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 is often treated with chemotherapy (drugs). If the cancer has spread to the bone, radiation treatments may lessen pain and prevent further spread.

How long will the effects last?

Metastatic cancer can usually be controlled only for a limited time. Talk to your doctor about the expected course of your disease. Every prediction of your outcome is, of course, an informed guess and you may prove it wrong.

How can I take care of myself?

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

• Keep a positive outlook.

• Learn relaxation and meditation techniques to help control fear, anxiety, and stress.

• Get plenty of rest.

• Eat nutritious meals.

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

What can be done to help prevent metastatic colon and rectal cancer?

After you are first diagnosed with colorectal cancer, follow your treatment plan carefully. It may help avoid the spread of cancer or delay metastasis as long as possible. See your doctor immediately if any signs or symptoms of cancer recur.