Receiving a diagnosis of colorectal liver metastases can be frightening. But can it be cured?
The answer might surprise you.
Hartford HealthCare’s Jocelyn Maminta recently spoke with surgical oncologist Charles Cha, MD, with the Cancer Institute at St. Vincent’s Medical Center in Bridgeport about treatment options when colon cancer spreads to the liver.
“Colon cancer originates from the lining of the large bowel that can be the colon or the rectum,” Dr. Cha explained. “Typically, it starts out as a polyp and then it grows over time to a cancer.”
When caught early with screenings, such as colonoscopies, colon cancer is treatable. If a polyp is found, it can be removed during a colonoscopy before it has the chance to turn into cancer. When it does spread, it is most commonly to the liver.
“When you have stage four colon cancer, unlike other types of cancers, it is still potentially curable,” Dr. Cha said. “The main feeding vessel for the liver comes from the bowel. The liver serves like a filter for tumor cells.”
Dr. Cha continued by explaining that tumors will lodge and stick in the liver and not go beyond that point. If tumors are caught in the liver, “We can almost go back in time to the point where we’ve removed all the liver tumors and it’s as if the cancer never metastasized.”
Treating colorectal liver metastases takes a multidisciplinary approach with a team comprised of a liver surgeon, oncologists, radiologists and pathologists who determine the best strategy to remove the tumors.
“The number and size of tumors does not matter,” Dr. Cha said. “What matters is if we can come up with a strategy of either one or multiple stage operations to remove all of the tumors.”
The liver is the only organ in the body that can regenerate. A common approach to treatment is removing part of the liver, waiting for it to grow back to 100% and then removing other parts affected by cancer.
“There’s other strategies where we can combine removal of some of the tumors with ablative techniques,” he said. “We have microwave probes where we can burn some of these tumors. We have strategies where we give chemotherapy first to shrink the tumors and then we go back and remove them.”
Patients are considered cured eight years following the original liver resection without a recurrence.
Signs and symptoms of colon cancer include:
- A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool
- Rectal bleeding or blood in your stool
- Persistent abdominal discomfort, such as cramps, gas or pain
- A feeling that your bowel doesn’t empty completely
- Weakness or fatigue
- Unexplained weight loss
- Changes in bowl habits
- Pencil thin stools
- Weight loss
New guidelines now recommend that the average person get screened for colon cancer beginning at age 45 (it was 50). People at increased risk may benefit from earlier or more frequent testing.
If you answer yes to any of the following questions, talk with your doctor about getting screened.
- Are you over the age of 45?
- Do you have a family history of colon cancer or polyps?
- Are you of African-American or Ashkenazi Jewish descent?
- Do you have Crohn’s disease or ulcerative colitis?
- Do you have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer?