How To Deal With Stage 4 Colon Cancer
Oliver Eng, MD, is a double board-certified surgeon and surgical oncologist and an Assistant Professor of Surgery at the University of Chicago.
How can you best cope when you learn you have stage 4 colon cancer? What decisions will you need to make and what do you need to know to make the best choices for yourself personally?
Let’s look at what having stage 4 colon cancer means, how long people usually live with this stage of the disease, and what you need to know to make the best decisions possible.
Survival Statistics For Stomach Cancer
Survival statistics for stomach cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival.
There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for stomach cancer and what they mean to you.
Certain Factors Affect Prognosis And Treatment Options
The prognosis and treatment options depend on the following:
- The stage of the cancer .
- The patients general health.
When gastric cancer is found very early, there is a better chance of recovery. Gastric cancer is often in an advanced stage when it is diagnosed. At later stages, gastric cancer can be treated but rarely can be cured. Taking part in one of the clinical trials being done to improve treatment should be considered. Information about ongoing clinical trials is available from the NCI website.
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Age Diet And Stomach Disease Can Affect The Risk Of Developing Gastric Cancer
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for gastric cancer include the following:
- Having any of the following medical conditions:
- Eating a diet high in salted, smoked foods and low in fruits and vegetables.
- Eating foods that have not been prepared or stored properly.
- Being older or male.
- Having a mother, father, sister, or brother who has had stomach cancer.
How Long Can You Live With A Stage 4 Diagnosis One Extreme
I thought I’d share this story which a visitor to the CRUK Health Awareness road show told me last week.
I was giving out some leaflets to the public when a lady politely refused and then smiled.
She said it was just over 30 years since she was first diagnosed with advanced bowel cancer, has since had bits chopped off various organs and has had more sessions of chemo than she cared to remember.
An extreme example I know, but it gave me some hope.
Hat off to her! We all like a good news story.
It’s amazing the difference from some stage 4 cancers to another. There is a lady who was in our local paper who was given weeks to live, she had been diagnosed with bowel and liver cancer, there was no healthy liver left. She started chemo straight away and 3 months later the liver had shrunk back to its normal size. She had chemo every other week for 18 months and the tumour has continued to shrink. This lady was only 33 when diagnosed… This gives people hope
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Surgery To Remove Stomach Cancer
If stomach cancer is found early, has not spread or has not spread far you may be able to have surgery to remove it.
Surgery will remove part or all of the stomach. They may also need to remove parts of other organs around the stomach.
Recovery from surgery to treat stomach cancer can take a long time. The specialist team looking after you will discuss all the benefits and side effects.
Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for stomach cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the stomach.
- Regional: The cancer has spread outside the stomach to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body, such as the liver.
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How Is Stomach Cancer Diagnosed
Your provider will review your medical history, ask about your symptoms and perform a physical exam that may involve feeling for a mass in your stomach. They may order several tests to diagnose and stage stomach cancer.
Staging allows your provider to assess how much the cancer has spread. With stomach cancer, staging ranges from 0 to IV . Stage 0 means the cancer hasnt spread beyond your stomach lining. Stage IV means that its spread to other organs.
Providers dont screen for stomach cancer in the U.S. because its so rare. Still, if you have a condition that increases your risk, your provider may recommend regular procedures like an upper endoscopy to detect cancerous changes. Ask your provider about their recommendations based on your risk.
Eating After Your Gastrectomy
Without your stomach, you arent able to handle regular portions of food and may not even feel hungry. Even if you are not hungry, it is important to remember that nutrition is a vital part of your health.
You will need to eat smaller amounts of food more often six to eight small meals a day. Your doctor or nutritionist may also recommend that you stay upright for some time after eating. Your health care team can help you adjust your diet if you are having problems eating.Some patients may experience a condition called dumping syndrome. When part or all of the stomach is removed, the food that is swallowed quickly passes into the intestine, leading to problems with nausea, diarrhea, sweating and flushing after eating. There are treatments to help with these symptoms.
Since the stomach is no longer there to do the grinding and breakdown of food, it is important that patients take small bites and thoroughly chew the food, Farma said.
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How Bad Is It When Bowel Cancer Has Spread To The Liver And Lungs
The most usual site where colon cancer metastasizes is the liver of the patient . However, cancer might metastasize to the patients lungs, the peritoneum, the brain, the membranes that enclose the abdominal cavity as well as other regions. In this case, there might be various treatment options or combinations of them available to the patients.
For those metastatic bowel cancer patients who have only some metastases to their lungs and/or liver, eliminating the metastases may sometimes contribute to long-term survival. However, for many other patients of colon cancer- stage 4, these treatments cannot be performed. In this case, the aim of the treatment becomes to try to manage cancer for extending life while improving the quality of life at the same time. In this situation, the question is not Can colon cancer be cured? Rather, palliative care is provided to the patients for relieving the symptoms of stage 4 colon cancer.
Selecting The Best Timing For Conversion Surgery
Optimally, surgery is performed when the tumor has decreased most in size in response to chemotherapy and before chemotherapy resistance allows it to grow again . This literature review found interval times between chemotherapy and surgery ranging from 4 to 391 days . Yoshida et al. estimated the optimal operation opportunity to be after a CR or PR response is determined following chemotherapy , with a mean interval time for resection after chemotherapy of approximately 126 days . However, a randomized phase II study by Yoshikawa et al. reported that 26 weeks after completion of neoadjuvant chemotherapy might be adequate . This is consistent with results from many studies listed in Table 2. Thus, there are currently two perspectives for optimal surgery time among surgical oncologists: patients who have achieved the indications of surgical treatment after definitive chemotherapy should have conversion surgery performed, or the chemotherapy duration could be extended to 6 months or even 1 year. After the disease condition is stable, conversion surgery could then be carried out, possibly increasing patient benefits and safety. Both views are reasonable, however whether one is superior remains to be further explored with additional evidence needed.
Table 2. Time of interval to surgery, postoperative chemotherapy, overall survival, and median survival time.
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Can You Live A Normal Life Without A Stomach
It may be surprising to learn a person can live without a stomach. But the body is able to bypass the stomachs main function of storing and breaking down food to gradually pass to the intestines. Absent a stomach, food consumed in small quantities can move directly from the esophagus to the small intestine.
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Tests That Examine The Stomach And Esophagus Are Used To Diagnose Gastric Cancer
The following tests and procedures may be used:
- Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken.
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual amount of a substance can be a sign of disease.
- Complete blood count : A procedure in which a sample of blood is drawn and checked for the following:
- The amount of hemoglobin in the red blood cells.
- The portion of the sample made up of red blood cells.
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How Long Will A Person With Stage 4 Colon Cancer Live
Stage 4 colon cancer is known to be the most progressive stage or grade of this disorder. At this stage, this disease may also be referred to as metastatic colon cancer. However, first of all, you are required to understand what does stage 4 cancers mean and that not all of them are compulsorily alike. As per the general definition, a stage 4 colon or bowel cancer is that which has progressed or metastasized beyond the colon of the person. There are many various sites to which cancer can spread. Due to this reason, it is considered that all statistics pertaining to late-stage colon cancer survival are prone to be misleading. Each colon cancer is different. The body of every person as well as the general health and the medical conditions of the person has to be different. Therefore, the time period for which a person with colon cancer- stage 4 can live is also different from one individual to another.
Dr Rudra Prasad Acharya, with above 10 years’ experience, can provide the best cancer surgery in Delhi. Check out below everything you need to know about stage 4 colon cancer, its diagnosis, treatment, expectations, and overall outlook.
What Causes Pancreatic Cancer
Pancreatic cancer is believed to be caused by genetic changes , however, the exact cause for these mutations is unknown. Risk factors for developing pancreatic cancer include:
- This is one of the most common causes of pancreatic cancer
- About 25% of pancreatic cancers are thought to be caused by cigarettesmoking
- The risk of developing pancreatic cancer is about twice as high among smokers compared to those who have never smoked
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Immunotherapy And Clinical Trials
Some stage 4 mesothelioma patients may qualify for clinical trials. Clinical trials investigate the value of various treatment combinations for late-stage mesothelioma or test newer options such as immunotherapy.
In some cases, experimental treatments such as gene therapy can help stage 4 patients survive far past their prognosis. A 2022 clinical study showed that gene therapy taken via orally inhalable drugs could be a viable treatment for malignant pleural mesothelioma.
Treatment For Metastatic Cancer
There are treatments for most types of metastatic cancer. Often, the goal of treating metastatic cancer is to control it by stopping or slowing its growth. Some people can live for years with metastatic cancer that is well controlled. Other treatments may improve the quality of life by relieving symptoms. This type of care is called palliative care. It can be given at any point during treatment for cancer.
The treatment that you may have depends on your type of primary cancer, where it has spread, treatments youve had in the past, and your general health. To learn about treatment options, including clinical trials, find your type of cancer among the PDQÂ® Cancer Information Summaries for Adult Treatment and Pediatric Treatment.
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What Happens If Youve Been Told Your Cancer Cannot Be Cured
If you have advanced stomach cancer, it might be very hard to treat. It may not be possible to cure the cancer.
If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.
Finding out the cancer cannot be cured can be very hard news to take in.
You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.
They will work with you to help manage your symptoms and make you feel more comfortable.
The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.
Total Gastrectomy Or Oesophagogastrectomy
If your cancer is in the middle or at the top of your stomach, you may need to have a total gastrectomy. If the cancer is close to the end of your oesophagus, where it meets your stomach, you may need to have an oesophagogastrectomy.
If you have a total gastrectomy, the end of your gullet will be joined to the top of your jejunum . If you have an oesophagogastrectomy, the remaining part of your gullet will be joined to your jejunum.
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A Possible Role For Immunotherapy Early In The Disease
Nivolumab binds to the protein PD-1 on T cells, which are a type of immune cell. By binding to PD-1, nivolumab prevents the protein from interacting with the PD-L1 protein on cancer cells and allows T cells to attack cancer cells.
Among patients with the highest PD-L1 levels in the CheckMate 649 trial, at a minimum follow-up of 12 months, the median overall survival was 14.4 months in the combination therapy group versus 11.1 months in the chemotherapy-alone group.
But the researchers also found more modest improvements in median overall survival among patients with lower PD-L1 levels and in the study population overall. Bristol Myers Squibb, the maker of nivolumab, sponsored the trial.
In the ATTRACTION-4 trial, with a median follow-up period of 11.6 months, median progression-free survival was 10.5 months in the combination-therapy group versus 8.3 months in the chemotherapy-alone group. The study was funded by ONO Pharmaceutical and Bristol-Myers Squibb.
Three years ago, Dr. Allegra noted, another checkpoint inhibitor, pembrolizumab , was approved for treating patients with advanced gastric cancer or gastroesophageal junction cancer that has worsened despite two or more types of treatment.
We have known that there is a role for immunotherapy in treating gastric cancer in the later stages of disease, said Dr. Allegra. These new findings demonstrate that the approach can benefit patients as a first-line treatment.
What Are The Different Stages Of Stomach Cancer
Stomach cancer is staged based on the severity of cancerous cell growth and spread. Adenocarcinoma is initially evaluated by the tumor, node metastasis system.
- T: How deeply has the tumor spread into the stomach wall?
- N: Has the stomach cancer spread to the lymph nodes?
- M: Has the stomach cancer spread to other parts of the body?
After the TNM staging information has been taken into account, the cancer is staged at 0 or 1 to 4. Tumor classifications for staging are as follows:
- Stage 0 is early cancer on the surface of the stomach lining.
- Stage 2A or 2B, commonly with deeper stomach wall involved
- Stage 3A or 3B or 3C, commonly with lymph node involvement
- Stage 4 means cancer has metastasized elsewhere in the body outside of the stomach.
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