Colorectal cancer, metastatic or recurrent

Metastatic cancer is cancer that has spread to other parts of the body. When colon or rectal cancer spreads, it most often spreads to the liver. Sometimes it spreads to the lungs, bones, or other organs in the body.

Colon and rectal cancers can return months or years after treatment. This is called recurrent cancer. If the original cancer was removed before it was able to spread, the chances that it will return are lower.

The most common symptoms of metastatic or recurrent colorectal cancer are:

• A change in bowel habits, such as narrow stools or frequent diarrhea or constipation.
• Blood in the stool, or stools that look like black tar.
• Loss of appetite.
• Pain in the belly, especially gas pains, cramps, or a feeling of fullness.
• Unexplained weight loss.
• Constant tiredness (fatigue).
• Cough or shortness of breath.
• Headache or confusion.

Some people don't have any symptoms for some time.

If your cancer has spread, you may have other symptoms.

Colon or rectal cancer that has spread or returned is diagnosed using a physical exam and several tests, including:

• An abdominal ultrasound to find the cause of pain or swelling in your belly.
• A colonoscopy to see if cancer has returned to your intestine.
• Blood tests to find out if cancer has returned or to find the cause of symptoms such as weakness or fatigue.
• A chest X-ray to find the cause of symptoms such as persistent coughing or chest pain.
• A CT scan, an MRI, or a PET scan to see if the cancer has spread into the chest or organs in the belly or pelvis.
• A brain CT scan or MRI to look into symptoms such as confusion or paralysis.
• A biopsy of the liver or lung to find out where the cancer cells have spread.
• A bone scan to find out if cancer cells have spread to the bones.

Treatment for metastatic or recurrent colorectal cancer is based on things like the location of the cancer, your overall health, and what matters to you. The main treatments are:

Surgery.

This may be an option if the doctor thinks all of the cancer can be removed. It may be done to remove cancer in the colon or rectum or cancer that's spread to other organs, often the liver or lungs.

Chemotherapy.

These medicines kill fast-growing cells, including cancer cells and some normal cells. It may be used with or instead of surgery. It may be combined with targeted therapy or immunotherapy.

Other treatments may be used. For example, the doctor may use extreme cold or heat (thermal ablation) to destroy liver tumors. Radiation therapy may help shrink tumors and relieve symptoms.

A clinical trial may be a good choice.

Your doctor will talk with you about your options and make a treatment plan.

There are things you can do at home to help manage the symptoms of cancer and the side effects of treatment. Your doctor may also give you medicines to help with certain side effects.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Eat healthy food. If you do not feel like eating, try to eat food that has protein and extra calories to keep up your strength and prevent weight loss. Drink liquid meal replacements for extra calories and protein.
• Get some physical activity every day, but do not get too tired.
• Take steps to manage your stress, such as learning relaxation techniques. To also help reduce stress, get enough sleep, eat a healthy diet, and take time to do things you enjoy.
• Think about joining a support group. Or discuss your concerns with your doctor or a counselor.