Created by
« home page
Dr. Amit Dilip Bhatt

For any patient, the diagnosis of colon cancer in Stage 4 evokes a multitude of emotions including fear of impending death, fear of complications arising from treatment, and fear of permanent disability with colostomy.

Let us understand the common scenarios faced in day-to-day clinical practice. To begin with, Stage 4 colon cancer means the cancer of the large intestine, which has spread to distant sites such as the liver or lungs. Usually, if the disease has spread to the whole body, systemic therapy is recommended as the treatment.

However, surgical care can be sought in special cases with a single operable mass in the liver, if found feasible by the specialist oncosurgeon. Usually, systemic therapy for colon cancer in Stage 4 uses a combination of chemotherapy drugs given as intravenous infusion over a period of three days and repeated fortnightly. And, these are called FOLFOX or FOLFIRI regimens.

In addition, as per the National Comprehensive Cancer Network guidelines, use of targeted therapy or biological agents called Cetuximab or Bevacizumab may be used depending upon the presence or absence of mutations in the tumor cells. An oncologist would be the right person to be consulted for this treatment planning and understanding the therapy options. Another miracle drug is immunotherapy, which works well in patients who harbor an abnormality in their tumor cells called Microsatellite Instability (MSI).

An oncologist helps the patient to understand the treatment options in Stage-4 colon cancer, get the specialized mutation markers on the tumor cells, plan therapies as per efficacy and tolerability of the patient and administer them in specialized treatment centers. The most essential move in this stage is selecting the right drug for the right patient.

This article has been written by Dr.Amit Dilip Bhatt, MD, DNB, FMO, ECMO, Ms Mol Onco, Director, Avinash Cancer Clinic & Dr. Lata Bhatt Cancer Centre, Consultant Medical Oncology, Poona/Jehangir/Joshi/ONP Prime/MJM/Sanjeevan/Lakshya.