"In the past, chemotherapy was the only option for patients with advanced colorectal cancer, which often spreads to the liver. But now, aggressive approaches to surgery executed by multidisciplinary teams that bring together colorectal and liver specialists are improving survival and even curing many of these patients," observes Michael A Choti, M.D., Director of the Johns Hopkins Colon Cancer Center.
A recent study from Johns Hopkins found that more than 50% of patients undergoing complete surgical removal of metastatic tumors in the liver survived for at least five years. This is far better than in years past.
"All patients with advanced colorectal cancer who may be eligible for surgery -- particularly patients with spread confined to the liver -- should be evaluated by an experienced liver cancer surgeon," Dr. Choti recommends.
If liver surgery is an option, you may be able to schedule it at the same time as your colorectal operation. These procedures used to be performed separately as a rule, because doctors were concerned about the danger of a lengthy, invasive dual operation. "But recent advances have allowed us to safely combine these procedures, sparing the patient from the risk and discomfort of two operations," Dr. Choti notes.
More patients whose cancer has spread to the peritoneum (a membrane that lines the abdominal cavity) may also be helped, thanks to increasingly aggressive surgical approaches. But Dr. Choti cautions that more studies are needed.
Medical follow-up is crucial to detect recurrences early. After treatment, most colorectal cancer patients should have checkups and a tumor marker blood test (a carcinoembryonic, or CEA, test) every three months for the first two years and then every six months for up to five years. Your doctor may also recommend an annual computed tomography (CT) scan.
Follow-up colonoscopies to detect new colon poylps or cancers are necessary one year after surgery and then every three years if no new polyps are seen. If a complete colonoscopy could not be performed preoperatively, the first postoperative colonoscopy should be done within four to six months of surgery.
