Colon cancer is not the friendliest of words one wants to hear, but that is just the reality for some people. Such was the story of Phil Scamihorn, a husband and a father of five, who was diagnosed with stage four colon cancer in the year 2012. Luckily he fought, survived and beat cancer. This is one of many cases of people who survived cancer at such a late stage. This is to show that there are a couple of factors that could determine the success rate, procedures, and regimens that could be followed to get the desired result of being totally devoid of the disease and the good news is that it is possible.
The colon is the terminal part of the human body’s digestive system and it also takes part in the excretion of waste and unwanted nutrients. It is commonly referred to as the large intestine. Its major function is the removal of water and nutrients as it pushes the excretory product out of the body with the smooth muscles lining its wall. The colon carries out this function very well but sometimes there may be some complications or simply anomalies that could either range from inflammation, infection and or cancer.
Cancer of the large intestine is one of the most common cancers worldwide, coming behind lung and breast cancer (only in women). Cancer of the colon is usually grouped with that of the rectum, the terminal part of the colon and together they are called colorectal cancer. These cancers of the bowel are very disturbing as they grow from the inner lining of the wall and may occlude the normal passage of waste product through the colon leading to even further complications.
Most people susceptible to this disease are old people, because as we age every system in our body starts to degenerate gradually. Other risk factors include a history of the same cancer in the family, colon polyps, which are outpouching of the intestines or even presence of one of the autoimmune colon disease, ulcerative colitis. Cancer is always grouped into stages in what physicians refer to as TNM classification, grouping cancers depending on their size, invasion of surrounding lymph nodes and how these cancerous cells have spread to other parts of the body, termed metastasis.
The stages range from stage zero up to stage four. The fourth stage can be divided even further based on the whether the metastasis is only to one organ or it has spread to more than one. Since the stage four colon cancer is characterized by its involvement with other organs, its prognosis is a bit gloomy as most estimates put the survival rate at about five years. However, like the introduction illustrated, there have been survivors who are doing great and fine for up to a decade after their diagnosis and some are still counting. Statistics are only estimates based on past scenarios and these cases differ uniquely from one person to the other, therefore it is always advisable to seek a second opinion from other experts who are experienced in dealing with stage four colon cancers.
Is There an Alternative to Chemotherapy for Colon Cancer?
The basic treatment at earlier stages of the bowel cancer is surgery. This is done by prompt excision of the polyp or even a partial removal of the particular section of the large intestine involved, in a process called partial colectomy. In some cases, where the Doctor suspects the cancer might resurface, they may suggest and carry out adjuvant chemotherapy, which is the chemotherapy after the initial surgery is carried out, in order to thoroughly eradicate the cancerous cells from the system. Radiation therapy may be introduced in patients that are not capable of withstanding the stress of surgery.
At the fourth stage of colon cancer, there is almost no option that will not involve the use of chemotherapy. Chemotherapy is the main course of action, either as a support to the surgery or as the main regimen. Although surgical removal is usually done after considerable shrinking of cancer, it is also helpful in situations when the metastases in other regions are still small in size as well. The most common areas of metastases are the liver and lungs. The major reason for the use of chemotherapy is that cancer at this stage is already far spread and malignant. So, chemotherapy is used to curb this aggressive spree, which has developed in size and in the invasion of other surrounding tissues.
Stage 4 Colon Cancer Treatment Options
According to an article on the official website of the American cancer society, these are some of the more common regimen utilized in treating the stage of cancer:
- FOLFOX: leucovorin, 5-FU, and oxaliplatin (Eloxatin)
- FOLFIRI: leucovorin, 5-FU, and irinotecan (Camptosar)
- CapeOX: capecitabine (Xeloda) and oxaliplatin
- FOLFOXIRI: leucovorin, 5-FU, oxaliplatin, and irinotecan
One of the above combinations plus either a drug that targets VEGF (bevacizumab [Avastin], ziv-aflibercept [Zaltrap], or ramucirumab [Cyramza]) or a drug that targets EGFR (cetuximab [Erbitux] or panitumumab [Vectibix])
- 5-FU and leucovorin, with or without a targeted drug
- Capecitabine, with or without a targeted drug
- Irinotecan, with or without a targeted drug
- Cetuximab alone
- Panitumumab alone
- Regorafenib (Stivarga) alone
- Trifluridine and Tipiracil (Lonsurf)
Basically, the choice of treatment is based on a lot of factors that include the overall wellbeing of the person and former treatment when applicable. The progress will be closely monitored to access the continuation of the combination or introduction of a new one. When there are genetic mutations in the cancerous cells after initial chemotherapy, immunotherapy pill such as pembrolizumab (Keytruda) might be introduced.
In advanced cases, radiation therapy is used to alleviate the pain being experienced by patients or even totally prevent it as it also shrinks the tumor just in time for it to be excised surgically. Although on its own it does not promise any form of cure, therefore when it is being recommended it is necessary to understand its goal so as not to misunderstand its purpose.
What is the Best Treatment for Stage 4 Colon Cancer?
As simple as it, the support from family and friends is crucial for people fighting cancer. As Scamihorn reiterated, that the solidarity and encouragement he received from his community was enormous. His family was accorded full support because people knew that the battle was that of his entire family. After he became NED (No evidence of disease), he has also offered his support to victims, both on the ground and online.
There’s really no particular best treatment for stage four colon cancer, but physicians through experience have found better ways of combining chemotherapy, which is still the main treatment, with radiation and surgery to bring about the best results possible.
Colorectal Cancer: Stages | Cancer.Net. Cancer.Net. Retrieved 27 January 2018, from https://www.cancer.net/cancer-types/colorectal-cancer/stages
Hoffman, M. (2016). The Colon (Human Anatomy): Picture, Function, Definition, Problems. WebMD. Retrieved 27 January 2018, from https://www.webmd.com/digestive-disorders/picture-of-the-colon#1
Stoppler, M. Colon Cancer Symptoms, Signs, Treatment, Survival Rate & Pictures. MedicineNet. Retrieved 27 January 2018, from https://www.medicinenet.com/colon_cancer/article.htm#colon_cancer_facts
Treatment of Colon Cancer, by Stage. (2017). The American Cancer Society medical and editorial content team. Retrieved 27 January 2018, from https://www.cancer.org/cancer/colon-rectal-cancer/treating/by-stage-colon.html
Worldwide data | World Cancer Research Fund International. (2015). Wcrf.org. Retrieved 27 January 2018, from http://www.wcrf.org/int/cancer-facts-figures/worldwide-data
JOHNSON, B. (2017). Beating Stage 4 Colon Cancer: A Patient Shares His Journey. Healthblog.uofmhealth.org. Retrieved 27 January 2018, from https://healthblog.uofmhealth.org/cancer-care/beating-colon-cancer-trust-treatment-and-community