With the improvement of people’s living standard, the incidence of colorectal cancer is increasing; in addition, since most of the blood from the colorectum flows back to the liver, the liver is the organ where colorectal cancer is most likely to metastasize. According to statistics, nearly half of the patients will find liver metastasis at the same time when colorectal cancer is diagnosed, and even if liver metastasis is not found at the time of diagnosis, half of the patients will develop liver metastasis after colorectal surgery. Therefore, this article will answer some common questions about liver metastasis of colorectal cancer
1.Is liver metastasis from colorectal cancer advanced cancer? Is there any chance of treatment?
According to the National Comprehensive Cancer Collaboration Network (NCCN) guidelines, liver metastases from colorectal cancer are stage IV, which is commonly referred to as advanced stage. For many other types of tumors, stage IV is considered incurable and can only be treated with palliative chemotherapy, but liver metastases from colorectal cancer is an exception. Due to the development of comprehensive treatment and liver resection technology, colorectal cancer liver metastasis has become a very special kind of “advanced but curable” tumor.
2.Can colorectal cancer liver metastasis be cured? How can it be cured? How long can I live?
It is entirely possible. At present, surgical resection is the internationally recognized standard method to cure liver metastasis of colorectal cancer. However, if liver metastases can be surgically removed and combined with chemotherapy and other comprehensive treatments, about half of the patients can survive for more than 5 years, and in tumor treatment, we consider 5 years of survival as the standard of cure.
3.Can all colorectal cancer liver metastases be cured?
Although the rate of liver metastasis in colorectal cancer is high, only less than 30% of patients have the chance to get surgery at the initial detection. However, thanks to the advent of targeted drugs in recent years, their combination with conventional chemotherapy has been able to increase the rate of patients suitable for surgery to more than half. In other words, even if the liver metastasis is unresectable at the time of discovery, it still has a chance to be transformed into resectable through drug therapy, thus gaining a chance of cure.
4. So, is it true that liver metastases that can be resected should be operated directly?
For liver metastases, it is not easy to decide whether the tumor should be operated directly by whether it can be cut or not. If the liver metastasis is resectable but has some high-risk characteristics, such as high tumor markers, large lesions or multiple lesions, etc., it means that the liver metastasis is in a progressive state, and if surgery is performed at this time, it is likely to recur immediately after resection. In this case, you can choose to do several cycles of chemotherapy before surgery to curb the arrogance of tumor growth, and then do radical surgery to beat it completely.
5.What are the targeted drugs? Are all people suitable for using targeted drugs?
If general chemotherapy drugs are a shotgun, then targeted drugs are undoubtedly like a precise sniper rifle, hitting the command of tumor proliferation precisely. Of course, the choice of sniper rifle is very important, and different types of sniper rifles should be chosen for different nature of tumors. Then how to determine the nature of tumor? There is a test called Ras, and according to this result, the most appropriate targeted drug can be chosen to kill the tumor cells to the greatest extent.
6.The doctor said my chemotherapy is effective and the tumor is shrinking obviously, does that mean I don’t need surgery?
The good effect of chemotherapy means that the tumor can respond well to chemotherapy, which predicts a good prognosis. But it does not mean that this can avoid surgery. Because even if chemotherapy beats the tumor to the point that MRI and CT cannot detect it, there may still be remnants of tumor cells that cannot be seen by existing examination methods. So take advantage of the good effect of chemotherapy to cut out the tumor radically in order to get the maximum chance of cure.
7.After I got liver metastasis, my doctor prescribed CT, MRI and PET-CT, is it useful?
Preoperative careful evaluation is a prerequisite for radical resection. Currently, the most accurate test for evaluating liver metastases is the enhanced MRI, which can detect a minimum of 5mm-1cm lesion. The size, number, and score of metastases must be carefully localized before surgery. In addition, CT of the chest, CT of the pelvis or PET-CT is also needed to clarify whether there are metastases in other parts of the body other than the liver to avoid unnecessary surgery.
8.Some people say that cutting the liver will affect the life expectancy, is it reasonable?
For liver metastasis of intestinal cancer, several words must be remembered.
(1) Surgical resection is the only curable method.
(2) The treatment of liver metastases ultimately determines survival.
(3) The liver has a strong regenerative capacity. A normal liver that has not undergone chemotherapy will regenerate after 70% of it has been removed, and the remaining 30% of it will regenerate.
(4) After liver resection, there is no impact on future life and diet as long as the recovery is smooth.
(5) In the face of liver metastasis of colorectal cancer, both patients and family members must overcome negative and pessimistic emotions and actively treat it as early as possible, which is the key to improve the cure rate of colorectal cancer.
Summarize
The occurrence of liver metastasis in colon cancer patients or the recurrence of liver metastasis in patients who have already undergone resection of liver metastases is not an incurable disease. Patients and their family members should not give up treatment, but should seek early medical consultation, take correct treatment under the guidance of surgeons, and surgically remove liver metastases as much as possible.