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What Causes Stage 4 Colon Cancer, Is There a Suitable Way to Treat It

The colon, also known as the large intestine, is the part of the body that removes water, some nutrients, and salts from chyme (partially digested food). The undigested remains of food then pass through the rectum and leave the body from the anus.

Colon cancer occurs because of the development of tumorous growths in the large intestine. In the United States, it has become the third most common type of cancer, the third leading cause of death resulting from cancer, and the second most common reason for cancer-related deaths in men and women combined. Colorectal cancer, which is the co-occurring of colon cancer and rectal cancer, is also widespread. Rectal cancer begins in the rectum, the final 12 to 15 cms of the large intestine, before the anus.

The American Cancer Society (ACS) estimates that 104,270 new cases of colorectal cancer will be reported this year, and 52,980 people are expected to die from colorectal cancer in the United States in 2021.

Healthcare experts advise people over the age of 45 years to attend regular screenings for colon cancer.

What Is Stage 4 Colon Cancer

Stage 4 colon cancer, also called advanced bowel cancer, begins when cancer cells metastasize from the primary tumor in the colon to distant tissues and organs. The liver is the most common site of invasion for colon cancer, but it can also spread to the lungs, lymph nodes, brain, or abdominal cavity lining.

According to the American Cancer Society (ACS), the 5-year relative survival rate for stage 4 colon cancer with distant spread is 14%. However, each patient is different, and a person's survival rate depends on many other factors.

Stage 4 colon cancer has three further stages - 4A, 4B, and 4C. (Colorectal cancer staging)

Stage 4A

Stage 4A colon cancer means that cancer cells, through the lymphatic system or the bloodstream, have spread to 1 distant site, such as the liver, but the peritoneum lining remains uninvaded.

Stage 4B

Cancer has metastasized to 2 or more organs but hasn't reached the peritoneum tissue.

Stage 4C

Stage 4C indicates that cancer has spread to distant sites and also to the lining of the peritoneum.

In the TNM classification:

Stage 4A is the equivalent to:

  • any T, any N, M1a

Stage 4B is the equivalent to:

  • any T, any N, M1b

Stage 4C is the equivalent to:

  • any T, any N, M1c

Symptoms of Stage 4 Colon Cancer

Numerous people with colon cancer do not experience any symptoms. Colon cancer usually causes no signs and symptoms in the early stages. Though, symptoms become more noticeable with the progression of the disease. When colon cancer produces symptoms, at any stage, they include:

  • Blood: Usually, blood (dark red or black) appears in the stool

  • Long and thin stools: These indicate that something is obstructing your colon. The blocking could be due to a tumor or polyp.

  • Nausea and vomiting: This can be due to obstruction caused by the tumor

  • Constipation and diarrhea: Although these often indicate other less severe health issues, you should see a doctor if they persist.

  • Abdominal discomfort or bloating: The blockage created by colon tumors causes difficulty in emptying the bowels completely. As a result, the person might feel bloated or full.

  • Fatigue: Experiencing much more tiredness or weakness than a person usually does could signify bleeding of the tumor and the person is losing iron.

  • Sudden weight loss: Losing 10 pounds or more without changing your diet and workout practices suggests you may have cancer, particularly if you have other colon cancer symptoms too.

Additional symptoms that you may encounter usually depend on where cancer has metastasized.

Liver

Colon cancer can reach the liver through the hepatic portal vein, which is a blood vessel that joins the GIT and liver.

Several people do not have manifestations when colon cancer initially invades their liver. If at any point they do feel symptoms, they may include:

  • Loss of appetite

  • Weight loss

  • Fever

  • Fatigue

  • Itching

  • Abdominal pain

  • Swollen legs

  • Jaundice

Lungs

Cancer cells can break off from the primary tumor and get into the lungs from different body parts, including the colon, because blood reaches the lungs after circulating through the rest of the body. The settling of cancer cells in the lungs can influence breathing. Indications include:

  • A persistent cough

  • Pain in the chest

  • Blood in the phlegm

  • Difficulty in breathing

  • Weight loss

Peritoneum

Cancer cells can travel from the tumor in the colon and settle in the peritoneum lining of the abdomen. Symptoms include:

  • Pain or discomfort in the belly

  • Loss of hunger

  • Weight gain or loss

Bones

If colon cancer reaches the bones, it can make them weak by causing them to lose stored calcium. This metastatic invasion of bones may lead to:

  • Bone pain

  • Constipation, loss of appetite, and nausea due to high levels of calcium in the blood

  • Damaged bones

  • Numbness or weakness in the limbs

  • Back or neck ache

Causes

Healthy body cells follow an orderly process of development (growth, division, and death). But in cancer, these cells grow and multiply at an abnormal rate, and cell death doesn't happen at an appropriate time in their life cycle. The majority of colon cancer cases arise from noncancerous tumors known as adenomatous polyps, forming on the inner surface of the colon or large intestine. Cancer cells travel from the primary tumors through the bloodstream and lymph systems and settle in different body parts when malignancy occurs. Cancer continues to grow in nearby and distant healthy tissues in metastasis. As a result, the patient's condition becomes more serious and less treatable.

The specific causes of colon cancer are not known, but some potential risk factors include:

Polyps

Clinical evidence has revealed that colorectal cancers frequently stem from adenomatous polyps that usually undergo dysplastic changes before progressing into metastatic colon cancer in 10 to 15-years. The early diagnosis and removal of polyps will decrease the incidence of colorectal cancer. Colon cancer often originates from the formation of precancerous abnormal tissue growths/polyps in the large intestine.

The commonest types of polyps include:

  • Adenomas: These form on the mucous membrane of the large intestine and might look like the normal lining of a healthy colon but appear different when examined under a microscope. They can be cancerous and result in malignant colon cancer if a doctor does not remove them on time.

  • Hyperplastic polyps: These are typically benign but can give rise to colon cancer.

Genes

The alteration of the healthy colonic epithelium to a precancerous adenoma and eventually to invasive cancer requires a buildup of mutational genetic modifications, either acquired (somatic) or inherited (germline). After genetic damage or changes in DNA, uncontrolled cell division can occur.

A person is more predisposed to inheriting colon cancer if one of their family members receives a diagnosis before turning 60. This risk becomes double if more than one relative has cancer of the large intestine.

Different acquired conditions also raise the chances of developing colon cancer, such as:

  • Attenuated familial adenomatous polyposis

  • Familial adenomatous polyposis (FAP)

  • Gardner syndrome (another type of FAP)

  • Turcot syndrome (another variant of FAP)

  • Juvenile polyposis syndrome

  • Lynch syndrome

  • Muir–Torre syndrome (a variant of Lynch syndrome)

  • MYH associated polyposis

  • Peutz–Jeghers syndrome

It is possible to have these genetic features and not have colon cancer because cancer will not grow until an environmental factor activates it.

Traits, Lifestyle, and Diet

For colon cancer, age is a considerable risk factor. Almost 91% of patients with colorectal cancer are over the age of 50 at the time of diagnosis. Though, it is becoming prevalent in people under 50 as well.

Colon cancer more likely affects individuals who are obese, have inactive lifestyles, and who smoke. Diet and nutrition play leading roles in the development of the colon, as it is a significant part of the digestive system. Diets low in fiber can contribute.

According to one 2019 study, people using the following in excessive amounts are at high risk for colon cancer:

  • saturated fats

  • alcohol

  • red meat

  • processed meat

Underlying Health Problems

A person might have a heightened chance of developing colon cancer after getting radiation therapy for any other cancer.

Some health conditions and their treatments have been found linked with increased risk for colon cancer.

These involve:

  • diabetes

  • previous treatment with radiation therapy for another cancer

  • inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis

  • acromegaly (growth hormone disorder)

Survival Rates For Colon Cancer

According to the American Cancer Society, the overall 5-year survival rate for colon cancer patients is 63%.

In case the diagnosis of cancer is made at a localized stage, the survival rate is 91%. If colon cancer has invaded the nearby tissues, organs, or lymph nodes, the 5-year rate of survival is 72%.

When colon cancer spreads to far-off body parts, the 5-year rate of survival is 14%.

Treatment Options for Stage 4 Colon Cancer

To treat invasive colon cancer that has reached other organs requires a combination of different treatments. These may include:

  • surgery

  • chemotherapy

  • radiation therapy

  • targeted therapies

  • immunotherapy

  • clinical trials

Personalized Targeted Therapies At Silver Cancer Institute and Center for Chronic Disease

Personalized Molecular Biomarker Testing

Dean R. Silver forms a special treatment plan for each patient through personalized testing offered at Silver Cancer Institute and Center for Chronic Disease.

  • Evaluation with "predictive biomarkers" allows the use of novel targeted therapies to inhibit cancer's growth pathways.

  • Chemosensitivity testing is a new way to assess which chemotherapy will work best for the patient. The most appropriate chemotherapy in low doses and natural substances are used after being tested for efficacy.

  • All colon cancer patients should undergo testing in order to ascertain the effectiveness of the new checkpoint inhibitors. When indicated, tests are run for the assessment of tumor mutational burden and microsatellite instability to determine which immunotherapy must be given to the patient.

Combination Therapy Provides the Best Results

Includes:

Low-dose metronomic chemotherapy does not produce any adverse effects as high-dose chemotherapy. Combining it with natural treatments reduces chemotherapy resistance and contributes to tumor cell death.

Also, checkpoint inhibitor therapy shows an immensely beneficial response in patients when combined with chemotherapy and vaccines.

To activate the patient’s immune system, they are given autologous whole tumor vaccines and dendritic cell vaccines created in the laboratory with the patient's circulating cancer cell sample obtained from his blood.

All these therapies are synergistic and produce the most effective results when used together.

For further information on stage 4 colon cancer, feel free to get in touch with us! Contact us online or call us at 480-860-2030.

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