A person with stage 4 bowel cancer has cancer that has spread to distant sites, such as the liver and lungs. It’s also sometimes called advanced bowel cancer.
The first step to treating stage 4 bowel cancer is finding out how far the tumour has spread. This is done by checking if it has invaded the outside of the bowel wall, how many lymph nodes it has affected (N) and if it has reached other parts of your body (M). Doctors use this information to decide on a treatment plan for you.
If the cancer is confined to your colon, surgery may be an option. Doctors will try to remove as much of the cancerous tissue as possible and will also remove nearby lymph nodes. They might also suggest chemo, either before or after surgery. The FOLFOX (5-FU, leucovorin, and oxaliplatin) or CapeOx (capecitabine and oxaliplatin) regimens are commonly used for this stage of colon cancer.
But if the cancer has spread to other tissues, it is unlikely that surgery will be an option. If it has spread to the liver, doctors might perform a procedure called hepatectomy. This involves removing the part of your liver with the tumour and some surrounding tissues. If the cancer has spread to your lungs, a procedure called pleuroscopy might be an option. This involves making a small incision in the belly and creating a pouch for collecting feces.
Other symptoms of stage 4 bowel cancer include tiredness, weight loss, bleeding, or breathlessness caused by the tumour causing a hole in your bowel wall (perforation). Some people don’t experience any symptoms at all.
Some people who have stage 4 bowel cancer want to know more about their prognosis, such as how long they might live. But it’s important to remember that survival figures are based on statistics and that each person is different. It’s important to discuss with your healthcare team what information you do or don’t want to receive.
It’s also worth mentioning that palliative care is available to help you manage your symptoms and improve your quality of life, whatever stage of cancer you are at. It’s a team of doctors, nurses and other professionals who specialise in helping you cope with the symptoms of a serious illness. For example, they might help you manage pain or discomfort or teach you how to manage your diet and other day-to-day activities.