Colon Cancer: Stage IV Standard Treatments

By definition, with stage IV colon cancer, the cancer has spread (metastacized) to other organs. The liver is the most common site for metastasis.

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

• For the primary colon tumor:
  • If the tumor is obstructive or blocking the bowel: surgery (also known as  colon resection). To learn about surgery for colorectal cancer, click here.  
  • If there is not a bowel blockage chemotherapy is started first. Surgery may be considered later.

• Chemotherapy which is generally;
  • A combination of drugs known as FOLFOX 
  • A combination of drugs known as FOLFIRI
  • A combintaion of drugs known as CapeOx
  • Bevacizumab
  • Cetuximab or 
  • Panitumumab  (PAN-ih-TOO-myoo-mab) 

For metastatic disease in the liver and surgery or resection is not an option due to a variety of factors, you may be deemed a good candidate for liver directed or targeted therapies. Liver directed treatments include ablative therapies, Embolization and internal radiation. Liver directed treatments can be used alone or in combination with chemotherapy and/or biologic agents.

National Comprehensive Cancer Network ("NCCN") has created colon cancer treatment guidelines which can be accessed at www.nccn.org. Guidelines are published in versions for professionals and for patients. Registration is required.

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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