Treatment for metastatic bowel cancer

If your cancer is advanced when it is first diagnosed you may be offered chemotherapy to keep it under control. You may have just one chemotherapy or a combination of chemotherapies.

Some people with bowel cancer that has spread receive precision medicine or immunotherapy which are different types of treatment to chemotherapy.

Ask your oncologist about the choices available to you, and the combination option.

In some circumstances you may have surgery.

The choice of treatment depends on:

  • The type of cancer you have
  • The size and number of secondary cancers and where they are in the body
  • The treatment you have already had

Surgery for metastatic bowel cancer

Surgery can be used in some situations to treat metastatic bowel cancer:
 
  • To slow the cancer
  • When the bowel is blocked
  • To remove secondary cancer
  • Surgery to control the cancer

Sometimes when there is a recurrence of bowel cancer in the bowel, it is possible to remove it. This is unlikely to cure the cancer because there are usually cancer cells elsewhere in the body.

Removal of the bowel tumour may however relieve any symptoms you may have. It may also be some time before the cancer starts to grow anywhere else.

Surgery to remove small metastatic cancers

Sometimes when bowel cancer metastasises in the liver or lungs and the cancer is small enough, or there are only one or two cancers, surgery to remove them may be an option.

This is not suitable treatment in every situation and is done more often for liver metastases than for lung metastases. If you have this type of surgery, you may also have chemotherapy before and after the operation.

To decide if this treatment is suitable for you, your specialist will look at:

  • Your general health
  • How advanced your cancer was when you were diagnosed
  • How quickly your cancer came back
  • How many secondary bo you have and their size
  • Where they are in the liver or lungs
  • How close they are to major blood vessels

Surgery for a blocked bowel

Sometimes bowel cancer can grow so that it completely blocks the bowel.

This is called a bowel obstruction.

The waste from the food you have digested cannot get past the blockage.

This can cause a number of symptoms such as feeling bloated and full, pain, feeling sick, vomiting, or constipation.

To relieve symptoms, it is sometimes possible to unblock the bowel by putting in a stent.

To put the stent in, the surgeon puts a flexible tube with a light at the end (called an colonoscope) into the bowel through your back passage through a procedure known as a colonoscopy.

The surgeon uses the colonoscope to see where the blockage is and pushes the stent through it.

The stent expands and holds the bowel open so that poo can pass through again. The surgeon leaves the stent in the bowel to keep it open. As well as relieving symptoms, this procedure gives specialists time to plan an operation to remove the blocked part of the bowel.

Another way to remove an obstruction is to operate and remove the affected part of the bowel, provided you are fit enough. It may be possible to close up the bowel again during the operation or you may need to have a colostomy.

Chemotherapy for metastatic bowel cancer

Chemotherapy to shrink a cancer and control symptoms is called palliative chemotherapy.

Treatment with chemotherapy at this stage is unlikely to cure your cancer, but it can help you live longer.

For metastatic bowel cancer, the aim of chemotherapy is to help you feel better.

If however, you are unhappy about the side effects, you do not have to continue with the treatment.

How do you know if chemotherapy is working?

Your oncologist will arrange a scan before you start treatment and again three months later. Your oncologist can measure the tumour on the scan and so will be able to see how well the treatment is working. The tumour may have become smaller or larger or remained the same size.

If it has remained the same size, your oncologist will want to talk to you about whether or not it is worth continuing with your treatment.

If the tumour has become bigger, despite your treatment, your oncologist will stop the chemotherapy and may suggest trying a different treatment.

 

Metastatic Bowel Cancer

Bowel Cancer Australia’s comprehensive resource regarding possible surgery and treatment options for metastatic cancer in the liver, lungs or peritoneum.

Liver, lung & peritoneal metastases

Liver metastases
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Lung metastases
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Peritoneal metastases
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Support for you

Bowel Cancer Australia’s essential support services are uniquely designed for you.

Email, call of video chat confidentially with one of our friendly nurses, nutritionists, or psychosocial support worker, plus access our resources, peer-to-peer buddy program, support group or podcast.