What is colorectal cancer, metastatic or recurrent?

Colorectal Cancer, Metastatic or Recurrent

Metastatic or recurrent colorectal cancer

Metastatic colorectal cancer occurs when cancer cells travel from the large intestine, through either the bloodstream or the lymph system, to other parts of the body and continue to grow in their new location. Recurrent colorectal cancer is cancer that has come back after treatment.

Metastatic colorectal cancer can be present at the initial diagnosis or may occur months to years after treatment for colorectal cancer. Metastasis can affect areas near the colon, such as lymph nodes, or organs in other parts of the body, such as the liver or lungs.

Treatment of metastatic or recurrent colorectal cancer depends on how far the cancer has spread, the symptoms, and the area of the body that is involved.

What happens when you have metastatic or recurrent colorectal cancer?

Cancer is the growth of abnormal cells in the body. If the cancer keeps growing, over time it will spread farther.

Colorectal cancer often spreads first to nearby lymph nodes. From there, it may spread to the liver, lungs, or other places in the body.

Recurrent colorectal cancer occurs when the cancer begins to grow again months or years after treatment.

What are the symptoms of metastatic or recurrent colorectal cancer?

Symptoms can include pain in the belly, blood in your stools, or more frequent bowel movements. If cancer spreads to the lungs, it can cause shortness of breath or cough. In the brain, it can cause headaches, seizures, dizziness, or confusion. If it spreads to the liver, it may cause jaundice or belly swelling.

How is metastatic or recurrent colorectal cancer treated?

Treatment for metastatic or recurrent colorectal cancer is based on things like the location of the cancer, your overall health, and what matters to you. The main treatments are:

This may be an option if the doctor thinks all of the cancer can be removed. It may be done to remove cancer in the colon or rectum or cancer that's spread to other organs, often the liver or lungs.
These medicines kill fast-growing cells, including cancer cells and some normal cells. It may be used with or instead of surgery. It may be combined with targeted therapy or immunotherapy.

Other treatments may be used. For example, the doctor may use extreme cold or heat (thermal ablation) to destroy liver tumors. Radiation therapy may help shrink tumors and relieve symptoms.

A clinical trial may be a good choice.

Your doctor will talk with you about your options and make a treatment plan.

How is metastatic or recurrent colorectal cancer diagnosed?

Colon or rectal cancer that has spread or returned is diagnosed using a physical exam and several tests, including:

Abdominal ultrasound.

An abdominal ultrasound takes pictures of the organs and other structures in your upper belly. It uses sound waves to show images on a screen. It helps the doctor find the cause of pain or swelling in your belly.


A colonoscopy (say "koh-luh-NAW-skuh-pee") lets your doctor see if cancer has returned to your intestine.

Blood tests.

These are done to find out if cancer has returned (carcinoembryonic antigen test, or CEA) or to find the cause of symptoms such as weakness, fatigue, fever, bruising, or weight loss (complete blood count).

Chest X-ray.

A chest X-ray is a picture of the chest that shows your lungs and airway. It helps find the cause of symptoms such as persistent coughing, coughing up blood, chest pain, or trouble breathing.

CT scan, MRI, or PET scan.

Images from these tests can help your doctor see if colorectal cancer has spread into the chest or organs in the belly or pelvis.

Brain CT scan or MRI.

Images of the brain help look into symptoms such as confusion, paralysis, numbness, vision problems, vertigo, or headaches.


If imaging tests showed a mass in the liver or lung, a liver biopsy or a lung biopsy might be done.

Bone scan.

This test helps your doctor find out if cancer cells have spread to the bones.

Who can diagnose and treat metastatic or recurrent colorectal cancer?

If you have been treated for colorectal cancer, doctors who can evaluate any new symptoms include:

  • Gastroenterologists.
  • Internists.
  • Family medicine physicians.
  • Colon and rectal surgeons.
  • Medical oncologists.
  • Radiation oncologists.

How can you care for yourself when you have metastatic or recurrent colorectal cancer?

Taking medicines as prescribed, eating healthy food, and getting enough sleep may help you feel better. To keep up your strength, eat food with extra protein and calories. Get some physical activity each day if you can. Manage stress with relaxation techniques. Consider joining a support group or talking with a counselor.

What is metastatic or recurrent colorectal cancer?

Metastatic cancer is cancer that has spread to other parts of the body. When colon or rectal cancer spreads, it most often spreads to the liver. Sometimes it spreads to the lungs, bones, or other organs in the body.

Colon and rectal cancers can return months or years after treatment. This is called recurrent cancer. If the original cancer was removed before it was able to spread, the chances that it will return are lower.

What causes metastatic or recurrent colorectal cancer?

Doctors don't know the exact cause of metastatic or recurrent colorectal cancer. Sometimes cancer cells are too small to be found by tests. These cells may continue to grow and show up later as metastatic cancer, even years after treatment.

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