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Can You Go into Remission with Stage 4 Colon Cancer?

Reviewed on 4/25/2019

Ask a Doctor

I have stage IV colon cancer. My doctor has been judicious about describing my survival chances, but I know the situation is pretty grim. I’m trying to hold onto hope. Can you go into remission with stage IV colon cancer?

Doctor’s Response

In stage 4 colon cancer, the cancer has spread from the colon to other organs and tissues in the body. It often spreads to the liver, but it can also spread to the lungs, brain, peritoneum (the lining of the abdominal cavity), or lymph nodes. A cure where the cancer is totally eradicated and will never return is rare at stage 4. However, remission, where symptoms are reduced or gone for a time, is possible.

Surgery is unlikely to cure the cancer at this stage but if there are only a few areas of metastases (spread) then they may be removed and it can help improve survival. Chemotherapy is usually given at this stage as well. Radiation may also be recommended.

Staging is the process of determining how far a tumor has spread beyond its original location. Staging may not be related to the size of the tumor. Treatment decisions also depend upon the stage of a tumor. Staging for colorectal cancer is as follows:

  • Stage 0 – The cancer is found only in the innermost lining of the rectum or colon.
  • Stage I – The cancer has not spread beyond the inner wall of the rectum or colon.
  • Stage II – The cancer has spread into the muscle layer of the rectum or colon.
  • Stage III – The cancer has spread to at least one lymph node in the area.
  • Stage IV – The cancer has spread to distant sites in the body, such as the bones, liver, or lungs. This stage is NOT dependent on how far the tumor has penetrated or if the cancer has spread to lymph nodes near the tumor.

Recovery from colon cancer depends on the extent of your disease before your surgery.

  • If your tumor is limited to the inner layers of your colon, you can expect to live free of cancer recurrence five years or more 80%-95% of the time depending on how deeply the cancer was found to invade into the wall.
  • If cancer has spread to your lymph nodes adjacent to the colon, the chance of living cancer free for five years is 30%-65% depending upon the depth of invasion of the primary tumor and the numbers of nodes found to have been invaded by colon cancer cells.
  • If the cancer has already spread to other organs, the chance of living five years drops to 8%.
  • If the cancer has reached your liver but no other organs, removing part of your liver may prolong your life with as many as 20%-40% of patients living cancer free for five years after such surgery.

Living with cancer presents many new challenges, both for you and for your family and friends.

  • You will probably have many worries about how the cancer will affect you and your ability to "live a normal life," that is, to care for your family and home, to hold your job, and to continue the friendships and activities you enjoy.
  • Many people feel anxious and depressed. Some people feel angry and resentful; others feel helpless and defeated.
  • For most people with cancer, talking about their feelings and concerns helps.
  • Your friends and family members can be very supportive. They may be hesitant to offer support until they see how you are coping. Don't wait for them to bring it up. If you want to talk about your concerns, let them know.
  • Some people don't want to "burden" their loved ones, or prefer talking about their concerns with a more neutral professional. A social worker, counselor, or member of the clergy can be helpful if you want to discuss your feelings and concerns about having cancer. Your primary care doctor or oncologist should be able to recommend someone.
  • Many people with cancer are profoundly helped by talking to other people who have cancer. Sharing your concerns with others who have been through the same thing can be remarkably reassuring. Support groups of people with cancer may be available through the medical center where you are receiving your treatment. The American Cancer Society also has information about support groups all over the United States.

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Reviewed on 4/25/2019
References
Charles Patrick Davis, MD, PhD coauthored this article

REFERENCE:

American Cancer Society. Treatment of Colon Cancer, by Stage. 19 October 2018. 3 January 2019 .

National Cancer Institute. Understanding Cancer Prognosis. 29 August 2018. 3 January 2019 .
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