Treating Recurrent Colorectal Cancer

Following your colorectal cancer diagnosis, your team of doctors will begin to advise you on the treatment options that are available and which are most suitable for your diagnosis. Depending on your stage, cancer/tumor type and genetics, some treatments may be more or less effective than others, and having a better understanding of what to expect can help you make more informed decisions.

In this series of articles, we cover the treatment that you may be recommended based on the cancer stage when you are diagnosed. We hope this helps you keep a positive mindset while preparing for the next phase of your journey with cancer.

This article will outline and explain the available and likely treatments for recurrent colorectal cancer.

Recurrent cancer indicates the return of cancer after initial treatment. Recurrence can manifest as local (near the original tumor site) or distant metastasis in other organs.

In cases of local recurrence, surgery (often followed by chemotherapy) may extend survival and potentially offer a cure. If surgical removal is not feasible, chemotherapy may be attempted initially. If it reduces the tumor size sufficiently, surgery might become an option, followed by additional chemotherapy.

Distant recurrence, commonly starting in the liver, may sometimes permit surgical intervention. When surgery is not an option, chemotherapy can be employed to shrink the tumors, which may then be surgically removed. Ablation or embolization techniques could also be considered for certain liver tumors. Ablation is the use of heat to destroy tumors, while embolization involves reducing blood flow to the tumor by injecting substances into an artery in the liver. If ablation or embolization is not suitable, radiation therapy may be considered.

In some cases where surgery is impractical due to extensive spread, chemotherapy and/or targeted therapies may be employed. Treatment protocols mirror those used for stage 4 disease. Immunotherapy is also an alternative treatment option for individuals with specific gene mutations, particularly for mutations pertaining to microsatellite instability.

The treatment available depends on prior therapies received, the timing of previous treatments, and overall health. Surgery may still be necessary at some point to alleviate colon obstruction or address other local issues. Radiation therapy may be considered to relieve symptoms.

Recurrent cancers can pose significant treatment challenges that may call for treatments that are yet to be readily available. Therefore, discussing the availability of clinical trials for novel treatments with your doctor may be advisable.