According to the 2017 data from the Hong Kong Cancer Registry, there were a total of 5,635 new cases of colorectal cancer, of which 23.5% were in stage 4, i.e., over 1,300 cases. Stage 4 colorectal cancer is considered late-stage and is regarded as a terminal illness in the past. However, with advances in technology and medicine, some cases of late-stage colorectal cancer can still be cured.
腸癌最常擴散的部位是肝臟，其次是肺部。有些個案，腸癌擴散到肝或肺的其中一小部分，而非廣泛擴散，現在來說，仍有機會做手術把受擴散影響的肝或肺組織切除，同一時間切除大腸內腫瘤的原發部位。當然，並非每個晚期腸癌病人都可以用這方法，現時一般做法是以多團隊模式會診，除了Oncologists，還可能包括肝臟外科醫生、胸肺外科醫生等，就個別的個案開會討論，以決定最適合的診療方案。其次，若晚期腸癌病人適合接受手術，一般會在手術後配合輔助性化療，希望盡量減低復發風險。
If colorectal cancer has spread extensively, doctors may not recommend surgery and instead focus on controlling the condition through chemotherapy, targeted therapy, and other treatments. In recent years, the variety of chemotherapy drugs has greatly increased, such as oral and injectable options, and different combinations to increase effectiveness. The addition of targeted therapy to chemotherapy often improves treatment outcomes, and many late-stage colorectal cancer patients who receive combined chemotherapy and targeted therapy have a longer survival period.
晚期腸癌的新療法不能不提免疫診療。初時多用於肺癌，近期已開始用於腸癌。癌細胞是很狡猾的，會偽裝成身體的正常細胞，令免疫系統無法把它辨認出來，因而無法對癌細胞攻擊。免疫診療並非直接殺死癌細胞，而是去除它們的偽裝，令病人的免疫系統可以把癌細胞辨認出來然後殲滅。當然免疫診療不是每個晚期腸癌病人都適合，須先經過檢測，但總算為晚期腸癌病人提供多一個希望。
The author is oncologist Dr. Ng Kim Pong
Sources:https://bit.ly/33fHsBY
