Stage IV colon cancer

Last Modified: April 10, 2005

Dear OncoLink "Ask The Experts,"
My brother has been diagnosed with Stage IV Colorectal Cancer. The tumor is a Mucinous adenocarcinoma and has spread into his abdominal area. He is a 55 year old Caucasian non smoker who was fit and healthy. His cancer was diagnosed when he developed an intestinal blockage.

My question is do you know if there are any clinical research programs for this type of cancer. My brother has been told that this is an extremely rare form of cancer. Is that correct? What are the recommended treatments?

Najjia N. Mahmoud, MD, Assistant Professor of Surgery at the Hospital of the University of Pennsylvania in the Division of Colon and Rectal Surgery, responds:

Stage IV colon cancer is usually treated with some combination of chemotherapy and surgery. If the patient is symptomatic, they may need surgery simply to divert the intestinal stream, bypass, or remove the tumor causing obstruction, allowing them to eat and drink normally.

"Mucinous adenocarcinoma" is a variant of adenocarcinoma--the most common of all the tumors affecting the colon. It is not particularly rare. This patient is young for this problem. His family (children and siblings) should be screened (colonoscopy) to make sure they are free of tumors or precursors (polyps) and to exclude a hereditary form of the disease.

There are clinical chemotherapy trials offered at University of Pennsylvania and other academic institutions. There are many potential regimens he may qualify for depending on his tumor and his other medical problems. One regimen is not necessarily right for all patients. Today, most chemotherapeutic options broadly use chemotherapies that target metabolic pathways and gene repair systems such as 5-FU or oxaliplatin, or "biologics" that specifically target growth factor receptors.