Stage 4 Colon Cancer Treatment


Colon cancer that has been diagnosed as Stage 4, is typically categorized into one of two subcategories referred to as Stage 4A (Any T, Any N, M1a) or Stage 4B (Any T, Any N, M1b).

Since in Stage 4 colon cancer, the cancer has spread from the colon to distant organs such as the liver, lungs or ovaries, surgery is not typically performed in order to try to cure the cancer, but rather to help alleviate uncomfortable symptoms. Most Stage 4 colon cancers are treated with combination chemotherapy regimens with or without other targeted agents.

Some of the most commonly used regimens to treat Stage 4 colon cancer include:

A triple combination of 5-FU, leucovorin and oxaliplatin
A triple combination of 5-FU, leucovorin and irinotecan
A double combination of capecitabine and oxaliplatin
A quadruple combination of leucovorin, 5-FU, oxaliplatin and irinotecan

All of these chemotherapy regimens also may be given with targeted agents, such as bevacizumab, cetuximab or pantimumab, which are designed to bind to specific proteins found on the surface of colon cancer cells in order to destroy them.

Radiation therapy also may be recommended to help alleviate any pain associated with the colon cancer.

About Staging

The stage of colon cancer at diagnosis, or the extent to which it is present in the body, is typically determined by a staging system developed by the American Joint Committee on Cancer (AJCC) called the TNM System. Determining the stage of the colon cancer is one of the most vital factors in determining the most appropriate treatment options.

The AJCC TNM system evaluates the tumor based on the following criteria:

T Category
Describes the size of the primary tumor, which is measured in centimeters. The colon consists of several layers that form the wall of the colon, so it is important to know the extent of the growth into the wall of the intestine.
N Category
Whether or not the colon cancer has spread to nearby lymph nodes.
M Category
Describes the absence or presence of distant metastasis, or spread of the cancer, to other organs.

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