Rectal Cancer: Stage IV: Treatments

Colorectal cancer is cancer  that generally occurs in the colon or rectum. (For a general overview, click here).

By definition, with rectal cancer stage IV, the cancer has spread (metastacized) to other organs in the body. The liver and the lungs are the most common sites for metastasis.

Standard treatment for Stage IV rectal cancer includes each of the following:

• Surgery for cancer in the rectum (also known as resection) if the tumor is obstructive or blocking the bowel. Surgery is not generally performed if the tumor is not blocking the bowel. To learn about surgery for colorectal cancer, click here.  
• Chemotherapy which is generally one of the following:
  • A combination of drugs known as FOLFOX 
  • A combination of other drugs known as FOLFIRI
  • Bevacizumab 
  • Cetuximab.
• External Beam Radiation Therapy (EBRT, Radiotherapy) to the tumor, to reduce (alleviate) pain
  • NOTE: When chemotherapy and radiation are given at the same time, it is known as   “ChemoRadiation”.
• Liver directed or targeted therapies. 
  • Liver directed treatments include Ablative Therapies, Chemoembolization and Internal Radiation through seed implants temporarily placed in or near the tumor (Brachytherapy) generally given prior to other treatments.
  • Liver directed treatments can be used alone or in combination with chemotherapy such as FOLFOX or FOLFIRI and/or biologic agents.

For information about choosing a treatment, click here.

Complementary/Integrative Treatments: Complementary or integrative therapies be of great use during treatment. These therapies include acupuncture, massage, meditation and relaxation techniques as well as other treatments.  

• Complementary/integrative treatments can help reduce symptoms or side effects, reduce stress and feelings of sadness, improve your mental outlook, improve your quality of life and help to relax you.
• These treatments are not meant to take the place of traditional treatment but instead are meant in this context to complement and integrate with traditional treatment. There is no scientific proof that any complementary treatment will cure colorectal cancer. It is possible they could negatively affect traditional treatment or cause serious side effects. It is important to tell your doctor about any complementary therapies you use and/or are considering. (For more information, click here.)

If existing therapies are not adequate discuss with your physicians the availability of a clinical trial for your cancer.  Clinical trials are studies performed with humans to test new drugs or combinations of drugs, new approaches to surgery or radiotherapy or procedures to improve the diagnosis of disease and the quality of life of the patient. A clinical trial may offer you the opportunity to receive a treatment that is not yet available for the general public. (For a clinical trials matching service, click here ).”

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