Options in Unresectable Metastatic Colorectal Cancer

Patient follow-up depends upon the stage of the colorectal cancer (CRC) as well as whether they are actively receiving treatment, radiation, or planning for surgery, states Cathy Eng, MD. A patient with early stage disease who has already had surgery is typically then treated with 6 months of chemotherapy. Communicating with patients regarding the extent of their treatment is important so that they can more easily make personal decisions, says Eng.

Metastatic CRC cannot be surgically cured, and chemotherapy is continued indefinitely for those who tolerate treatment and have appropriate laboratory values. These patients have incurable residual disease, and chemotherapy is given to prolong their lives, comments Eng. Individuals often need treatment breaks, which are typically given for 2 to 6 weeks.

It is difficult to tell patients that you cannot cure their disease, says John L. Marshall, MD. Oncologists should explain that the goal of therapy is to maintain a high quality of life, while also controlling the disease and minimizing toxicities. There is often a clinical trial available, adds Marshall.