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This topic is about metastatic and recurrent colorectal cancer. If you want to learn more about early-stage colorectal cancer, see the topic Colorectal Cancer.

What is colorectal cancer?

Colorectal cancer happens when cells that are not normal grow in your colon or rectum . These cells grow together and form polyps. Over time, some polyps can turn into cancer. This cancer is also called colon cancer or rectal cancer, depending on where the cancer is.

Metastatic cancer is cancer that has spread to other parts of the body. When colon or rectal cancer spreads, it most often spreads to the liver. Sometimes it spreads to the lungs, bones, or other organs in the body.

Colon and rectal cancers often return months or years after treatment. This is called recurrent cancer. If the original cancer was removed before it was able to spread, the chances that it will return are lower.

What causes metastatic or recurrent colorectal cancer?

The exact cause is not known, but the cancer is more likely to spread or come back if it is in a later, more advanced stage when it is first discovered.

Sometimes cancer cells are too small to be found by tests. These cells may continue to grow and show up later as metastatic cancer, even years after being treated.

What are the symptoms?

Some people do not have any symptoms. When they do occur, the most common symptoms are:

• Belly pain, especially gas pains, cramps, or a feeling of fullness.
• Blood in your stool or very dark stools.
• A change in your bowel habits, such as more frequent stools, thinner stools, or a feeling that your bowels are not emptying completely.
• Loss of appetite.
• Losing weight without trying.
• Constant tiredness (fatigue).

If your cancer has spread, you may have other symptoms, depending on where the cancer is. If it has spread to:

• The lymph nodes of your belly, it may cause bloating, a swollen belly, loss of appetite, or a feeling of fullness.
• The liver, it may cause pain on the upper right side of your belly, bloating, loss of appetite, or a feeling of fullness.
• The lungs, it may cause you to cough, spit up blood, or have a hard time breathing.
• The bones, it may cause bone pain, especially in your back, hips, and pelvis.
• The brain, it may cause problems with memory, concentration, balance, or movement.

How is metastatic or recurrent colorectal cancer diagnosed?

Colon or rectal cancer that has spread or returned is diagnosed using a physical exam and several tests, including blood tests, chest X-rays, bone scans, ultrasounds, and CT, PET, or MRI scans.

The diagnosis is usually confirmed with a biopsy. During this test, your doctor will take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.

If you have been treated for colon or rectal cancer in the past, it's important to have regular checkups to find any new cancer as soon as possible.

How is it treated?

Colon and rectal cancers that have spread or returned may be cured in some cases. Treatment may include surgery, radiation, chemotherapy, and targeted therapy. When the cancer cannot be cured, treatment can help you feel better and live longer.

Learning that you have cancer that has spread or come back can be very hard. Some people find that it helps to talk about their feelings with their family and friends. You may also want to talk with your doctor or with other people who have had this kind of cancer. Your local American Cancer Society chapter can help you find a support group.

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