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.
Colorectal cancer most commonly metastasizes to the liver, followed by the lungs. In some cases, colorectal cancer only spreads to a small part of the liver or lungs but not a large area. In such cases, surgery may be able to remove the affected liver or lung tissue while simultaneously removing the primary tumor in the colon. Of course, not every late-stage colorectal cancer patient is suitable for this approach. Currently, the general approach is multi-disciplinary consultation, which may include oncologists, liver surgeons, cardiothoracic surgeons, and so on. They discuss individual cases to determine the most suitable treatment plan. In addition, if late-stage colorectal cancer patients are suitable for surgery, they will often receive adjuvant chemotherapy after the operation to minimize the risk of recurrence.
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.
It is hard not to mention immunotherapy as another new treatment for late-stage colorectal cancer. Initially used for lung cancer, it has recently been used for colorectal cancer as well. Cancer cells are very cunning and can disguise themselves as normal cells in the body, making it difficult for the immune system to recognize and attack them. Immunotherapy does not directly kill cancer cells but removes their disguise, allowing the patient's immune system to recognize and destroy the cancer cells. Of course, not every late-stage colorectal cancer patient is suitable for immunotherapy and they must undergo examinations before deciding on the treatment option, but it can be considered as another hope for them.
The author is oncologist Dr. Ng Kim Pong
Sources:https://bit.ly/33fHsBY
