Colon cancer is the third most common cancer globally, with a worldwide incidence rate of 19.7 per 100,000 inhabitants per year. By 2030, this number is projected to reach 20 million. When colon cancer spreads to distant organs, it represents an advanced stage of the disease. The liver is the most commonly affected organ, but metastases can also occur in the lungs, lymph nodes, bones, brain, and abdominal tissue.
Age is the most significant risk factor for colon cancer, with the majority of patients over the age of 50. Other risk factors include a positive family history, chronic inflammatory bowel diseases, and lifestyle factors such as diet, alcohol consumption, smoking, and obesity. Neglecting symptoms of the disease can also increase the risk of colon cancer metastasis.
Liver metastasis of colon cancer usually do not cause symptoms until the disease is advanced. Symptoms may include weakness, fatigue, weight loss, lack of appetite, upper abdominal discomfort, and jaundice.
A colonoscopy with biopsy and pathohistological examination is the most reliable method for diagnosing colon cancer. Imaging methods such as CT, MR, and PET scans are used to verify the presence of distant metastases. In some cases, a percutaneous biopsy may be necessary to determine if a liver lesion is of colon cancer origin.
A group of medical experts consisting of surgeons, oncologists, gastroenterologists, radiologists and pathologists make the decision on the treatment plan based on the patient’s overall health and the extent of the tumour. The spread of the tumour is determined by diagnostic imaging methods like computed tomography (CT), magnetic resonance (MR) and positron emission tomography (PET).
A combination of systemic therapy and surgical treatment is used to treat resectable metastases. Neoadjuvant therapy with preoperative systemic chemotherapy can be prescribed to treat micrometastatic disease, which can improve patient survival. Conversion chemotherapy is used to reduce the diameter of the metastases, making operative treatment possible for potentially resectable metastases.
Surgical treatment is associated with a low mortality rate. In cases of liver resection, 60% of patients experience disease recurrence, and a potential second or even third intervention on the liver may be necessary.
A healthy lifestyle can play a significant role in preventing colorectal cancer. Consuming a diet rich in fruits, vegetables, fibre, and grains, engaging in physical activity, and maintaining a normal body weight can reduce the risk of developing colorectal cancer. Early detection through screening of colon cancer can significantly reduce the number of patients with distant metastases. Screening involves examining people without symptoms of the disease to detect changes in the colon, most commonly polyps, that may precede the onset of cancer or detect cancer in its early stages. The fecal occult blood test and colonoscopy are commonly used to detect colon cancer early. Regular check-ups are important for preventing distant metastases of the disease.
