Metastases in the intestine: difference from the primary tumor, symptoms

Causes

Scientists have been trying for several decades to answer the question: what could be the cause of this terrible disease? But we still haven’t been able to get an answer. Only a few reasons have been identified that can provoke a tumor or aggravate it:

the patient has bad habits: smoking, alcoholism;
sedentary lifestyle and excess weight;
a large amount of fatty and protein foods in the diet, a small amount or complete absence of fiber;
chronic gastrointestinal diseases: ulcerative colitis, Crohn's disease;
the presence of polyps or adenomas in the intestines;
heredity;
concomitant cancer diseases.

To prevent intestinal cancer, doctors recommend leading a healthy lifestyle and listening to your body. If you have chronic gastrointestinal diseases, you must be constantly monitored by a doctor. If polyps are detected, it is recommended to undergo a colonoscopy at least once a year.

Causes

When metastases are detected in the intestine, their large number makes it very difficult to identify the primary tumor. Removal of secondary lesions without destroying the maternal lesion is ineffective. Therefore, scientists are working to detect the primary neoplasm.

Intestinal metastases are associated with tumors in 3 organs:

The kidneys are paired organs located close to the intestines, so they affect it first. Secondary neoplasms appear at the 4th stage of pathological development, when the tumor grows through the renal capsule.
Liver, pancreas - organs affected by cancer spread metastases just like the kidneys. Secondary neoplasms primarily enter and develop in the duodenum. This development of the oncological process is extremely rare.
The rectum is the section that ends the entire intestine. It has its own venous system, so if the primary tumor is diagnosed in the rectum, then the appearance of its malignant particles in other parts of the intestine is considered metastasis. This happens at stage 4 of rectal cancer. When detecting malignant tumors in the intestines, the first thing to check is the presence of a maternal neoplasm in the rectum.

Metastases begin their rapid development when the patient’s body has exhausted its reserves.

Stages with metastases

Colon cancer occurs in four stages. The first is characterized by the appearance of a tumor within the intestinal wall without spreading beyond it or into the small intestine. At the second stage, the cancer grows through the entire thickness of the organ with possible spread to neighboring tissues. At the third stage, metastasis to adjacent lymph nodes appears. The fourth stage is the most dangerous. It already shows the spread of distant metastases not only to nearby tissues, but also to other internal organs, such as lungs, liver and others. It is impossible to cure metastasis 100%, but there are ways to slow down the progression of the disease, prolong the patient’s life and reduce or completely eliminate pain.

Bowel cancer treatment

The method of treatment depends on the results of the analysis of the current stage of metastasis, the biological nature of the tumor that has arisen and the stable condition of the body. They try to defeat intestinal cancer with the help of surgery, but this happens in the absence of distant metastases. During the operation, tumor tissue and regional lymph nodes are removed, and adjacent infected tissue will also be removed to prevent metastasis. Surgery will most effectively affect the body during chemotherapy and radiation.

Modern medicine is capable of removing single metastases in the liver, but extensive metastasis reduces the effectiveness of the operation due to the large size of the metastases. In this case, chemotherapy helps reduce it to the desired state.

To create the necessary conditions for the operation, the following methods are used:

— chemotherapy (stops tumor growth and reduces its size for surgery);

— radiation therapy (destroys possible micrometastases that may appear after surgery).

The latter method of exposing the body to ionizing radiation is rarely used, depending on the risk of metastasis.

Definition of symptoms

As the tumor grows in the intestines, deterioration will appear:

- vomiting will become more frequent, as will pain in the abdomen;

- if the intestines are affected by metastasis, bleeding will appear both during bowel movements and at any time;

- there is mucus in the stool;

Signs of deterioration are problems with appetite, a noticeable decrease in body mass category. In oncology, bleeding and possible penetration are noted as pathological complications in the intestine. Among this, metastases are a harbinger of the main threat - they confirm the spread of the tumor. Further symptoms depend on the location of cancer cells (lung cancer, liver cancer): dizziness, chest pain, etc. Often with colon cancer, metastases spread to nearby lymph nodes. It all depends on the location of the primary tumor.

Getting rid of metastases

Chemotherapy courses, which are the fundamental method of treatment, must take place at certain intervals - damaged tissues need time to recover.

Distant metastases of bowel cancer and most recurrences occur within the first 3 years after surgery. To prevent this from happening, you need to constantly consult a doctor and undergo a preventive examination - this will help identify the danger in advance. Your doctor may recommend a colonoscopy and an ultrasound of your internal organs.

How do metastases occur?

The appearance of metastases in the body from intestinal cancer is a complex and multi-stage process that has not been fully studied. The difficulty in diagnosing this phenomenon lies in the fact that, as a rule, metastases are microscopic in size. They cannot be detected on photographs or completely removed through surgery. The following stages of metastasis are distinguished:

The malignant cell separates from the site of the lesion and penetrates the wall of the blood or lymph vessel.
When a cell migrates through the vascular system, it gets stuck in the thinnest place. Here, not only its size plays a big role, but also the speed of fluid flow.
The cancer cell penetrates the vessel wall into nearby tissue.
The last stage in which the metastasis begins to develop and creates a new focal site.

Damage by metastases

In case of intestinal cancer, metastasis occurs along the chain: lymph nodes, liver tissue, lung tissue, pelvic bone tissue.
The lymphatic system, as the main one in the immune reaction, takes the blow of the degenerated cells. Lymph not only becomes inflamed and does not sufficiently perform protective and hematopoietic functions, but also carries cancer cells to other organs (lymphogenous pathway).

The second blow is delivered to the liver.

The liver is a large unpaired glandular organ that has several functions.

First: it neutralizes all toxic substances that enter the bloodstream. Second: the liver is an organ that synthesizes proteins, glycogen and bile. Third: lymph-forming function.

When cancer develops, it is the liver that bears the brunt. Transport fluids of the body (blood, lymph) carry tumor cells to the liver and metastases begin to form. A persistent pain syndrome develops.

Liver metastasis significantly worsens the general condition of the patient and leads to profound disability.

To treat intestinal cancer with liver metastases, drug and surgical methods are used. With their help, the general condition of the patient is significantly improved and life is prolonged.

In addition, metastases to the liver carry a number of dangerous complications. This may be compression of the inferior vena cava, the most powerful in the body, which accounts for more than half of the total blood flow. Venous stagnation causes persistent swelling of the lower extremities and phlebitis. Obstruction of the bile ducts causes obstructive jaundice, which in cancer gives a disappointing prognosis with the impossibility of treating the underlying disease.

Bilirubinemia leads to severe intoxication and death.

Surgical treatment (stenting, duct drainage) will only provide temporary relief to the patient. Treatment uses radiation and chemotherapy. The prognosis is unfavorable.

The lungs are in second place in terms of damage to metastases of intestinal cancer. The lungs are penetrated by a network of blood vessels with lymph nodes. It is with lymph that cancer begins to spread to the lungs. The complication is often asymptomatic, and the patient has no complaints. Therefore, a late visit to a doctor does not provide an opportunity to obtain a satisfactory prognosis. Five-year survival was not recorded. Patients with lung metastases die within two to three years.

The pelvic bones are the last to be affected. This indicates that the disease has entered its final stage. Half of patients die before reaching the five-year mark,

In case of intestinal cancer, distant metastasis is likely to the lymph nodes of the retroperitoneal space, peritoneum, uterine appendages, other pelvic organs, rectum, bladder and brain.

Oncology of areas of the digestive system is characterized by slow progression; therefore, metastases in intestinal cancer can develop over a long period of time. Tumor formations form over several years of life, increase in size, and during the period of complete filling of the intestine, their cells break off and begin to grow deep into its walls, reaching the blood and lymphatic vessels. Spreading throughout the intestine, they act as secondary foci of a malignant tumor.

Symptoms of intestinal cancer with metastases

In addition to the difficulty of diagnosis, metastases tend to “fall asleep” for an indefinite period. Thus, an undetected cancer cell can appear several years after the patient has been cured. Often metastasis can be asymptomatic and detected only during examination. The spread of the disease can be suspected if the following symptoms occur:

rapid unexplained weight loss;
weakness, lack of performance;
aversion to food and food smells;
constant severe pain in the abdomen, radiating to the lower back and groin area;
acute appendicitis;
inconsistent stool: diarrhea alternating with constipation;
blood, mucus in the stool (in some cases even pus may appear);
heaviness in the navel area, vomiting and belching;
development of anemia.

These symptoms can be a consequence of a number of other diseases, so if they appear, you should consult your doctor.

How long do people live with intestinal metastases and what will happen if they are not treated?

The appearance of metastases accompanies their spread to other organs in intestinal cancer. The disease in this course has several stages. In most cases, metastases are incurable. The exception includes lesions located in the liver, lungs or abdominal cavity. Therefore, the patient can be saved using a surgical technique.

In intestinal cancer, metastases act as malignant degeneration of organ cells. The lesion extends only to the mucous membrane.

Often the disease progresses in the rectum and colon. Therefore, the disease is called colorectal cancer. People over 40 years of age are at risk.

Patients do not live with the disease for a long time if metastases develop in the final stages.

The process of damage begins with a tumor, when the growth exceeds 5 cm in diameter, metastasis occurs to neighboring organs and epithelium.

Oncological disease is dangerous for patients due to the early manifestation of lesions. In most cases, patients die, but the disease has a favorable prognosis, unlike other types of cancer.

This occurs due to the manifestation of the first and early symptoms of metastases in colorectal cancer.

Classification of diseases in the digestive tract

Metastases in the intestine are divided into stages. Doctors count 5 stages in the course of a malignant tumor. Therefore, everything starts from stage 0. There is no cancer, but a formation in the form of a tumor or polyp is observed.

Then the following stages of intestinal metastasis are officially distinguished:

at stage 1, a node of altered epithelium develops, but there are no metastases;
Stage 2 branches into subtypes, which is characterized by a tumor without metastases (2A) or the presence of lesions on the lymph nodes (2B);
at stage 3, branching occurs again, when the disease completely grows into the intestinal wall (3A) or cancer cells spread in large numbers to the lymph nodes (3B);
Stage 4 is characterized by the appearance of growths and their spread to other organs with mucous epithelium.

The causes of cancer include diseases and conditions of the body. Therefore, the development of metastases is associated with genetic predisposition.

Intestinal diseases with inflammation of the walls of the mucous epithelium include the following pathologies:

polyposis in the rectum;
ulcerative colitis;
difficulty in bowel movements;
colon adenoma;
Crohn's disease.

In addition to diseases of the digestive system, bad habits influence the development of malignant tumor cells. Sometimes the cause of intestinal cancer is Lynch syndrome or a chronic form of proctitis.

Features of the clinical picture

Signs of the development of metastases do not have any features and appear like other diseases. Therefore, when diagnosing, doctors rely on the presence of the following symptoms:

sharp pain in the abdomen when turning and bending;
constant pain syndrome;
constipation;
bloating.

The main symptoms are similar to intoxication of the body. This manifests itself in attacks of nausea and vomiting. Sometimes unpleasant belching occurs. Symptoms of metastases in the intestines are manifested by bleeding from the anus.

When metastases grow, the patient begins to develop cachexia. This sign of bowel cancer is observed as weakness. Along with this comes weight loss. Then the patient develops symptoms of a psychological disorder.

Distribution routes

Malignant cells can spread throughout the body. There are only 3 main places where cancer spreads from the colon or colon. The formations develop into direct invasion of the walls of nearby organs. In addition, metastases spread through the blood or lymph.

When the rectum is damaged, malignant cells move to the liver tissue. Symptoms include pain in the right side in the area under the ribs. Symptoms spread to the skin as jaundice.

Sometimes metastases settle in the lung tissues, which impairs respiratory function.

What will happen if left untreated?

A complication of the disease is the transition to secondary growths. If proper treatment is not carried out on time, when the growth is a benign polyp, then the patient begins to struggle for life.

When cancer progresses, the patient's body is poisoned by cell decay products. Therefore, signs of the disease appear. When metastasis occurs to other tissues, metabolic processes are disrupted.

Therefore, additional diseases begin to develop:

malignant melanoma of the skin;
skin carcinoma.

Secondary growths appear only in the presence of a primary tumor.

Establishing a diagnosis

Diagnosis of metastases in the intestine is done in several stages. It is necessary to go to the hospital after the first sign appears in the form of abdominal pain when moving or bending.

First, the doctor examines and palpates the peritoneal area.

This is necessary to determine the presence of malignant neoplasms, which are manifested by bloating and changes in intestinal contractility.

Then the patient is required to undergo instrumental examinations:

rectoscopy;
sigmoidoscopy;
colonoscopy;
biopsy of malignant cells;
ultrasonography;
magnetic resonance therapy.

In addition to regular colonoscopy, a virtual examination is performed. In addition, the patient is referred for an X-ray of the intestine.

In addition to instrumental research methods, blood and urine tests are required from the patient for intestinal cancer. The results will immediately show a changed blood cell count.

In addition, with the development of metastases, elements of the breakdown of cancer cells are observed in the blood.

Therapy and prognosis

The only help for cancer patients in the initial stages of metastases is surgery. This is done when the tumor can be reached if its location is in the intestine. The operation involves removing part of the affected tissue. Therefore, the ends of the intestine are sewn together. Sometimes the method of endoprosthetics is used for this.

When the surgeon is unable to perform a conventional operation, a colostomy is performed. Unlike the arthroplasty method, the removal of cancer cells is carried out in combination with other therapies.

In addition to surgery, the patient is prescribed treatment with chemical medications. This treatment of metastases helps destroy cancer cells.

After removal of the growths, prevention is carried out in the form of chemotherapy.

The prognosis for intestinal cancer with secondary tumors depends on the stage of the disease. When metastases appear, the patient is able to continue to live normally only in 40% of cases. Sometimes this figure is 20%.

This occurs due to the stage of oncology. At the last stage, the patient is prescribed treatment to alleviate the symptoms. Delayed diagnosis occurs with any type of colloid cancer.

Therefore, medications can affect life expectancy and delay death by several years.

The development of a benign tumor into metastases in colorectal cancer leads to a slow process of dying. The clinical picture of oncology does not differ from other intestinal diseases.

Therefore, patients seek help in the last stages of cancer, when neoplasms give rise to a secondary tumor. In the early stages, treatment of growths and malignant cells is carried out by removing them.

If the disease has developed further, then the patient can only prolong his life with medications.

The information on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!

Rumyantsev V. G. Experience 34 years.

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Expert of the group for the study of inflammatory diseases. Author of more than 300 scientific papers.

We recommend to your doctor: What are the dangers of intestinal spasms during pregnancy?

Source: //gastrot.ru/kishechnik/metastazy

Diagnostic methods

The tumor is usually detected during colonoscopy. In the presence of neoplasms, a biopsy is required to identify the nature of the pathology. If bowel cancer is confirmed, imaging tests such as CT scans of the abdomen and chest are used to detect metastases. MRI of the pelvic organs is also used. In some cases, the doctor may prescribe a clinical blood test, which, of course, will not show a diagnosis, but will be able to assess the general condition of the body. In addition, a blood test is prescribed to identify tumor markers. In some cases, the extent of cancer can only be assessed through surgery. The following methods are also used in diagnosis: PET scan, chest x-ray, bronchoscopy, bone x-ray, liver angiography, diagnostic laparoscopy (if necessary).

Diagnostics

To make a final diagnosis, when a patient consults a doctor, the specialist begins to collect all the necessary information regarding the patient’s life history and his characteristic clinical picture. After this, the abdominal area is palpated and percussed.

At this stage, it is necessary to pay attention to the asymmetry of this zone and the increased dimensions. There is also a violation of peristalsis and a level of pain severity.

Next, a diagnostic examination is carried out, which includes a number of instrumental and laboratory studies.

Sigmoidoscopy

Allows you to examine the rectum and sigmoid colon.

Colonoscopy

Makes it possible to assess the condition of the entire intestinal section. Currently, virtual radiography is more popular in this procedure, as a result of which the specialist receives high-quality three-dimensional images of the pathological organ.

Biopsy

Necessary to confirm the presence of a malignant neoplasm. It involves taking a sample of the affected intestinal tissue followed by histological examination.

Ultrasonography

Peritoneal organs are examined.

Magnetic resonance imaging

Aimed at diagnosing the entire human body. It is prescribed for the purpose of identifying metastases that could affect other anatomical structures.

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An equally important role in making a diagnosis is played by laboratory testing, which includes:

biochemical analysis of blood fluid - with the development of cancer, the titers of protein fractions sharply decrease;
test to determine tumor markers - designed to identify a tumor and its level of malignancy.

An analysis of hidden bleeding is also prescribed, which can be performed several times.

Distribution order

As the disease progresses, the closest lymph nodes are the first to be affected. The system becomes inflamed, its ability to perform its functions fully decreases, and there is a risk of cancer spreading throughout the body. The liver, which performs not only the protective function of the body, but also lymph-forming, is the next to be affected. When malignant cells enter the liver, the disease develops very quickly and severe and persistent pain occurs. Also, when the disease spreads throughout the body, the lungs suffer greatly, since this organ is penetrated by small blood vessels and lymph nodes. The lesion resolves quickly, is asymptomatic and has a high mortality rate within 2–3 years. Then metastases penetrate into the pelvic bones. This is already the last stage of cancer with a very low five-year survival rate. Metastases can also penetrate into the retroperitoneum, genitals, bladder, small intestine and brain.

Distribution routes

Malignant cells can spread throughout the body. There are only 3 main places where cancer spreads from the colon or colon. The formations develop into direct invasion of the walls of nearby organs. In addition, metastases spread through the blood or lymph.

Because of this, cancerous lesions appear in the spine. This is frequent metastasis and the appearance of secondary malignant tumors. In this case, the symptoms are confused with the manifestation of an intervertebral hernia. When the rectum is damaged, malignant cells move to the liver tissue. Symptoms include pain in the right side in the area under the ribs. Symptoms spread to the skin as jaundice. Sometimes metastases settle in the lung tissues, which impairs respiratory function.

Metastases in the liver

Recently, methods of treating cancer cells common in the liver have advanced greatly.

Surgery. The most common type of treatment is resection of part of the organ. If the affected area does not exceed 70%, and the tumor has not grown into the tissue, it can be removed surgically.

RFA, or radiofrequency ablation. This is a therapy that is used when surgical intervention is not possible. Its essence is as follows: under the control of ultrasound or computed tomography, a needle is inserted into the focal area, through which a series of high-frequency current shocks are applied. The procedure is carried out in cases of a small focal manifestation, which is clearly visible on the photographs. It is also necessary that there is no risk of touching blood vessels.

Other methods. To combat metastases, chemotherapy is used both in addition to resection and as an independent treatment method. CyberKnife is a modern procedure that destroys a tumor using X-ray waves. For liver metastases, targeted drugs can also be used to block the development of growth molecules in cancer cells.

Intestinal metastases (carcinomatosis): symptoms, causes, treatment, prognosis

Recently, oncological diseases are being detected more and more often. Despite the fact that intestinal metastases are diagnosed in rare cases compared to primary type malignant neoplasms, they are also dangerous to human health.

In this condition, recovery occurs in exceptional cases. This is explained by the fact that metastases in the intestinal cavity are difficult to identify, in addition, they are practically not amenable to therapeutic measures.

What's happened

The main feature of a malignant tumor is that it can metastasize to anatomical structures nearby and distant from the affected organ.

Metastases are foci of secondary lesions in the development of many malignant neoplasms.

According to observations, it was found that metastasis occurs almost immediately from the moment of formation of primary tumors.

The distribution of its particles is carried out in two ways:

hematogenous;
lymphogenous.

Those particles that break away from the original lesion may remain inactive for a long time. The reason for the triggering of the mechanism of their development has not yet been established.

Some scientists suggest that there is a possibility that primary tumors may simply prevent metastases from spreading at the initial stages of development of the pathological process. There is also an opinion regarding the effect of the immune system, which leads to the destruction of a certain number of cancer cells.

When secondary type tumors form, malignant cells begin to actively multiply. Around the lesion, capillary networks are formed, which provide the neoplasm with nutrients. As a result, healthy tissues begin to receive less nutrients.

The process of metastasis is dangerous because it disrupts the functioning of all vital systems and organs.

Kinds

The spread of metastases in the intestine goes through 4 stages of its formation.

Zero

The presence of a cancerous process is not observed. However, polyps and tumor growths are already present.

First

This stage is characterized by the formation of an epithelial nodule. In this case, there are no metastases.

Second

This stage is divided into two categories. In the first, the formation of a tumor without metastasis is noted, and in the second, the lymph nodes are involved in the oncological process.

Third

Repeated branching is observed. That is, the pathology begins to grow into the intestinal walls. Metastases also spread to the lymph system in large numbers.

Fourth

Growths are formed, which are characterized by germination onto other anatomical structures that have mucous epithelium.

What types of cancer occur?

If metastases are found in the intestine, it will be difficult to identify the primary oncological process. In addition, if you remove only secondary lesions without eliminating the main tumor, this will not bring any result.

The process of metastasis to the organ of the digestive system can occur with the development of a malignant neoplasm in three anatomical structures.

Kidneys

There is a close location of the paired organs in relation to the intestines. As a result, he is the first to be affected by the oncological process.

The appearance of secondary neoplasms is observed in the fourth stage of cancer, which is characterized by tumor growth through the kidney capsule.

Rectum

This anatomical structure completes the entire intestine. A distinctive feature of this department is that it has its own venous system. As a result, when cancer is diagnosed in this organ, the tumor can metastasize to other intestinal areas

The development of this process is also noted at the final stage of cancer. Thus, if metastases are detected in the intestine, then first of all the primary lesion is looked for in the rectum.

Pancreas and liver

Metastasis in this case occurs according to the same principle as with kidney damage. But it is worth noting that such a process occurs in extremely rare cases.

Symptoms

When the intestine is damaged by metastases, the clinical picture may not always manifest itself with signs characteristic of a malignant process in this organ. Most symptoms resemble the development of various diseases occurring in the digestive tract. However, experts have identified symptoms that need to be addressed first.

First of all, we are talking about progressive pain. The more the intestines are affected, the more pronounced the pain syndrome will be, especially in places where nerve endings accumulate.

The lumen also begins to narrow, which often leads to its complete obstruction. This condition is usually accompanied by a violation of the act of defecation, bloating, and general intoxication of the body.

Dyspeptic disorders are characterized by the appearance of attacks of nausea and vomiting, rapid loss of body weight, as well as other conditions that arise against the background of the disintegration of a malignant tumor.

Often the oncological process is accompanied by bleeding from the anus, which indicates a violation of the integrity of the anatomical structure and an advanced stage of the disease.

As the disease progresses and metastasis spreads, the patient begins to develop cachexia. This is a pathological condition indicating the last stage of exhaustion of the human body. In this case, weakness and weight loss are observed.

Metastases in the intestine are detected, as a rule, already at the third or fourth stage of cancer. In this case, the patient must be operated on and undergo chemotherapy. It is important to take into account the fact that it is prescribed only if the disease is not in an advanced form.

By the last stage of the pathology, a large lesion has already formed in the organ, which involves not only the lower parts of the gastrointestinal tract, but also the lymph nodes and bone tissue.

If metastases are detected in the intestine at the last stage, the patient will experience:

complete lack of ability to work;
non-acceptance of food and smells;
blood, purulent and mucous impurities in stool;
feeling as if there is a foreign object in the abdomen.

With this diagnosis the prognosis is unfavorable. To alleviate the patient's condition, chemotherapy and surgery may be prescribed.

Diagnostics

At this stage, it is necessary to pay attention to the asymmetry of this zone and the increased dimensions. There is also a violation of peristalsis and a level of pain severity.

Next, a diagnostic examination is carried out, which includes a number of instrumental and laboratory studies.

Sigmoidoscopy

Allows you to examine the rectum and sigmoid colon.

Colonoscopy

Necessary to confirm the presence of a malignant neoplasm. It involves taking a sample of the affected intestinal tissue followed by histological examination.

Ultrasonography

Peritoneal organs are examined.

Aimed at diagnosing the entire human body. It is prescribed for the purpose of identifying metastases that could affect other anatomical structures.

An equally important role in making a diagnosis is played by laboratory testing, which includes:

biochemical analysis of blood fluid - with the development of cancer, the titers of protein fractions sharply decrease;
test to determine tumor markers - designed to identify a tumor and its level of malignancy.

An analysis of hidden bleeding is also prescribed, which can be performed several times.

Treatment

Based on the diagnostic results obtained, the tactics of therapeutic measures are selected.

The essence of treatment is to carry out several stages of therapy.

Operation

First of all, the primary tumor is excised. After this, secondary tumors are removed. It is worth noting that in most cases, during surgery, it is not possible to remove all growths due to their small size.

Chemotherapy

This procedure is necessary because its effect is aimed at destroying the malignant elements remaining after the operation.

Special chemicals are injected into the bloodstream, penetrating the tumor particles and destroying them.

Radiation therapy

It is also aimed at destroying unremoved metastases. Only in this case they are affected using a radioactive sensor. It is directed precisely to the site of the lesion, without affecting healthy areas.

Abdominal carcinomatosis

This serious condition occurs in the last stage of intestinal cancer and is characterized by damage to the organs of the inner lining of the abdomen by cancer cells, and many small focal areas appear. The prognosis for the patient in this case is disappointing, since surgical removal of the tumors in this case is not possible. Symptoms of carcinomatosis are:

accumulation of fluid in the abdominal cavity (ascites), which compresses organs and causes pain;
exhaustion;
constant nausea, vomiting, complete or partial lack of appetite.

Three stages of development of metastases in the abdominal cavity are identified: manifestation in a limited area, development of several tumor foci, total carcinomatosis. This disease is treated with a complex of procedures, including surgery, chemotherapy, hyperthermia, photodynamic therapy, and immunotherapy. However, it is impossible to completely get rid of metastases in the abdominal cavity. The prognosis for patients is extremely disappointing.

Peritoneal carcinomatosis in colon cancer

If cancer cells spread into the peritoneum, the prognosis is greatly worsened. Ascites occurs - fluid accumulates in the abdominal cavity. To combat this condition, they resort to laparocentesis - a puncture is made in the abdominal wall and the fluid is removed. A peritoneal catheter is installed to ensure constant drainage of fluid . Intracavitary chemotherapy is carried out, and according to indications, surgical interventions are performed aimed at ensuring the outflow of fluid from the abdominal cavity.

The average life expectancy of such patients when using classical treatment methods is 2–6 months. But over the past 20 years, a new treatment method has been actively developed: hyperthermic intraperitoneal chemotherapy (HIPEC). The procedure consists of two stages:

A surgical procedure is performed during which all visible lesions are removed from the abdominal cavity. This is a long (on average 6–9 hours) and complex operation.
Then the abdominal cavity is washed with a chemotherapy drug heated to 42–43 °C.

The HIPEC method has helped to greatly increase the survival rate of patients with peritoneal carcinomatosis.

Types of chemotherapy for colon cancer with metastases

This treatment method is used in the vast majority of cancers. More often it is used in conjunction with other treatment methods. If it is impossible to remove metastases surgically, one of three chemotherapy treatment options is used. The first option is used in accordance with the FOLFOX regimen and includes leucovorin (calcium folinate) - FOL, fluorouracil - F, oxaliplatin - OX. The second FOLFIRI regimen: also leucovorin - FOL, fluorouracil, but using irinotecan. The third CAPOX regimen (XELOX) uses capecitabine and oxaliplatin. Treatment is carried out until the tumor begins to progress with renewed vigor. Chemotherapy is also stopped or changed if side effects become severe. Often this method is prescribed in conjunction with the use of targeted drugs.

conclusions

«The concept of early systemic spread has been controversial, in part due to the challenge of quantifying this process in the human system and dependence on animal models. These data indicate that metastasis can occur early in human colorectal cancer development and highlight the critical need for earlier detection of aggressive disease. New biomarkers based on specific combinations of changes may allow potentially lethal colorectal tumors to be identified at an earlier stage so that they can be intercepted and treated appropriately, perhaps with treatments directed against their specific aberrations
' says Curtis.

The authors of another study argue that the effectiveness of treatment depends on identifying subtypes of colorectal cancer.

General symptoms

The onset of colon cancer, especially in the rectal segment, occurs latently, without symptoms. But as soon as the tumor begins to grow, the patient will begin to show the first signs in the form of: discomfort or pain during defecation, the release of mucus, blood or pus along with feces, visual changes in the nature of bowel movements (feces take on a ribbon-like shape).

Then the first serious symptoms begin to appear: constipation alternating with diarrhea, tenesmus (false urges), bloody-purulent feces with an unpleasant fetid odor, and others.

The disease continues to progress and along with it there is an increase in the severity of symptoms. Over time, disruptions occur in the functioning of some organs where the tumor has metastasized. The first target of rectal cancer is the regional lymph nodes, then the tumor metastasizes to the liver, lungs, spine with characteristic symptoms: icteric skin color, headaches, cough and hemoptysis, aching bones, etc.

The patient has general symptoms of cancer: chronic weakness, loss of appetite, rapid loss of body weight.

A rectal tumor is quite unpredictable and often causes severe complications. The patient may develop intestinal obstruction. Due to the growth, the tumor gradually blocks the large intestine in the segment of its localization, this causes stagnation of feces and stretching of the walls of the intestine itself.

Symptomatically, this complication manifests itself in the form of bloating, lack of release of gases and feces, abdominal pain, nausea and frequent vomiting. This condition is an emergency and requires immediate medical attention.

Also, rectal cancer can grow into the bladder or vagina, forming a fistula. This problem provokes the release of cloudy urine with the smell of feces. A number of inflammatory processes may occur: peritonitis, ascites, phlegmon.

The most common sites of metastasis of colon tumors

1) Metastases to the spine.

Metastases to the spine are one of the most difficult forms of metastasis of a malignant tumor, since this complication often indicates the development of cancer to stage IV (terminal), which in turn has a disappointing prognosis and ends in death in 90% of cases.

Most often, metastases to the spine come from internal organs, especially from parts of the colon (rectum, sigmoid, cecum, etc.), prostate and pancreas. The area of the pathological lesion in the spinal column and the resulting symptoms will depend on the location of the initial neoplasm that metastasizes.

If metastases of rectal cancer affect the thoracic region, symptoms will not appear immediately, since the bones of this part have some features in relation to other regions. Over time, the patient will begin to feel attacks of severe pain or discomfort in the interscapular part of the spine.

But for rectal cancer, the more typical area of damage to the spine is the lumbar region, which is difficult to diagnose due to the similarity of symptoms with kidney diseases. Signs of metastases can be: compression fractures of the vertebrae, provoked by severe static stress, and spinal cord injuries with further development of paralysis of the lower extremities.

In order to detect metastases in the spine, the patient needs to undergo a series of examinations:

X-ray of the problematic part of the spine in 2 projections (straight and side). On an x-ray, you can notice the presence of a focus of metastasis, which manifests itself in the form of darkening, and you can also notice the presence of vertebral fractures, in the form of deformation or destruction in the image.
CT is an innovative and most informative way to examine this problem. In addition to the capabilities of standard radiography, CT allows you to examine in more detail the part of the spine that the doctor needs.
Spinal puncture - collection of spinal fluid through a puncture between the vertebrae, with further examination of the resulting material for the presence of malignant cells. Prescribed in case of pathology affecting nerve structures.

2) Metastases to the liver.

Very often, oncological diseases of the colon are complicated by metastases to the abdominal organs, namely rectal cancer, cecum cancer and sigmoid colon cancer with metastases to the liver, kidneys, and adrenal glands. When a person's liver is affected, it causes a number of specific symptoms, which include:

Heaviness and pain in the right hypochondrium arise due to hepatomegaly with stretching of the Glissonian capsule covering the organ;
Jaundice and expansion of the vascular network of the abdomen, the accumulation of a large amount of fluid in the abdominal cavity, also indicate liver pathology;
Itching of the skin of unknown etiology;

The presence of such signs in parallel with rectal cancer may mean that cancer has metastasized to the liver. To confirm the presence of a complication, the patient is prescribed a number of additional examination methods: blood biochemical blood test, liver ultrasound, CT and MRI. If the ultrasound shows the presence of any abnormalities, doctors perform a biopsy, with further histological examination of the tissue, to determine the presence of malignant cells and determine the primary nature of the neoplasm.

3) Metastases in the lungs.

During metastasis of colon tumors to the lungs, of which rectal cancer most often metastasizes to this organ, the patient begins to be bothered by symptoms such as:

Frequent coughing attacks with difficulty breathing and shortness of breath;
Feeling of pain and pressure in the chest;
Hemoptysis after coughing.

To verify the presence of malignant cells in the lungs, doctors recommend undergoing chest x-ray, CT or MRI. If they find a suspicious lesion, a biopsy will be required.

Forecasts

The presence of distant metastases in the body is direct evidence that the process is at least in stage III, which means that the prognosis for further treatment and life will not be favorable.

If the patient has metastasized to the spine, then the prognosis is relatively positive, but only in the case of radical removal of the primary tumor and prosthetic replacement of the damaged vertebrae, with parallel chemotherapy. Such manipulations give patients a chance to live another 10 years, or even more.

If the cancer has spread to the liver, then all prognoses will depend on the type of cells and their location, as well as on the timeliness of diagnosis (for example, patients with metastases from the stomach live about 1 year, and if they came from the colon - up to 2 years). Without the necessary treatment, such patients live no more than 4 months, but if treatment has been started, the period increases to 1-1.5 years. Chemotherapy increases life expectancy by another 1 year.

Half of patients who have undergone liver resection live for about 5 years; if an organ transplant was performed, this can extend life by 3 years, but with a success rate of 75%.

Metastases to the lungs give a disappointing prognosis, since the average life expectancy of patients lasts about 5 years. If total resection of the colon tumor and chemotherapy were performed, then 50% of patients can live up to 10 years.