Colorectal Cancer, Metastatic or Recurrent - Treatment Overview

Treatment Overview

Your treatment for metastatic or recurrent colorectal cancer will depend on specific information about the cancer, your preferences, and your health.

Some cases of metastatic or recurrent colorectal cancer can still be cured. When it cannot be cured, treatment can help you feel better and live longer.

Your treatment may include:

• Surgery. If your cancer has come back in your intestine, surgery may be used to remove it. If it has spread to other parts of the body, it can sometimes be treated surgically. Cancer that has spread to the liver is sometimes successfully removed with surgery. For more information, see the Surgery section of this topic.
• Drugs. The use of drugs, either swallowed or injected with a needle, to treat cancer is called chemotherapy. Drugs can help you live longer by killing cancer cells that have spread to other parts of your body. They also can relieve pain caused by the cancer. For more information, see the Medications section of this topic.
• Radiation therapy. X-rays can be used to shrink colorectal tumors that may be causing blockages. They can also reduce bleeding or pain. For more information, see the Other Treatment section of this topic.
• Clinical trials. Clinical trials are studies of new or different ways to treat cancer.
• Home treatment. There are things you can do at home to manage the side effects caused by cancer and its treatments. For more information, see the Home Treatment section of this topic.

Dealing with your emotions

If you have been told you have metastatic or recurrent colorectal cancer, you may have many different feelings. Most people feel some denial, anger, and grief. There is no "normal" or "right" way to react. But there are things you can do to help manage your emotional reaction.

You may find that talking with family and friends helps. Some people find that spending time alone is what they need. You may also contact your local chapter of the American Cancer Society to find a support group. Talking with other people who have had similar experiences can be very helpful.

If your reaction is interfering with your ability to make decisions, it is important to talk with your doctor. Your cancer treatment center may offer counseling services.

Palliative care

As your cancer gets worse, you may want to think about palliative care. Palliative care is a kind of care for people who have illnesses that do not go away and often get worse over time. It is different than care to cure your illness, called curative treatment. Palliative care focuses on improving your quality of life—not just in your body, but also in your mind and spirit. Some people combine palliative care with curative care.

Palliative care may help you manage symptoms or side effects from treatment. It could also help you cope with your feelings about living with a long-term illness, make future plans around your medical care, or help your family better understand your illness and how to support you.

If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.

For more information, see the topic Palliative Care.

End-of-life issues

The 5-year survival rate for colorectal cancer that has spread to other parts of the body is 10%.¹ This means that 5 years after their cancer was discovered, 1 in 10 people are still living. It is important to remember that this is only an average. Everyone is different, and these numbers do not necessarily show what will happen to you.

You may wish to discuss health care and other legal issues that arise near the end of life with your family and your doctor. You may find it helpful and comforting to state your health care choices in writing (with an advance directive or living will) while you are still able to make and communicate these decisions. Think about your treatment options and which kind of treatment will be best for you. You may wish to choose a health care agent in case you become unable to speak for yourself.

A time may come when your goals or the goals of your loved ones may change from treating your illness to maintaining your comfort and dignity. You may choose hospice care. Hospice caregivers are concerned with enhancing the quality of your remaining life by keeping you as alert and comfortable as possible in a familiar environment with family and friends. Hospice programs offer services in your own home or in a hospice center, nursing home, or hospital.

Learning all you can about end-of-life issues may help you feel better. For more information, see one of the following topics:

Care at the End of Life

Choosing a Health Care Agent

Writing an Advance Directive

Hospice Care