Renuka Iyer with Patient

Metastatic Colon Cancer

Advanced Colorectal Cancer — When Your Cancer Has Spread

Dr. Iyer discusses how new clinical studies offer metastatic colon cancer patients more effective treatment options.

About 40 out of 100 people with colon cancer will develop cancer in distant sites at some point. This is called metastatic disease. Colorectal cancer most commonly metastasizes to the liver, lung or abdominal cavity.

Roswell Park’s colorectal oncologists are experts in advanced and complex cases of metastatic cancer. Nearly two out of three Roswell Park patients have stage 3 or 4 colorectal cancer at diagnosis — higher than the national average of 55% — reflecting our expertise and capability for treating advanced cases.

Patients with liver metastases can still be cured. Successful liver surgery demands specialized skills, by surgeons with advanced training and focus in liver surgery, and experienced support teams in anesthesia and interventional radiology. Our surgical teams have this advanced training and expertise. Boris Kuvshinoff, MD, MBA, FACS

Stage 4 Colorectal Cancer

Roswell Park takes a comprehensive approach to metastatic colorectal cancer and offers many advanced treatments to improve survival and quality of life, including:

  • Liver surgery (minimally invasive or open) to remove metastatic liver lesions or tumors, leaving enough healthy liver tissue to regenerate
  • Portal vein embolization prior to liver surgery where the main vein associated with the liver tumor is blocked (embolized), causing the healthy part of the liver to grow and allowing for a safer liver surgery to remove the tumors.
  • Ablation procedures such as microwave ablation or radiofrequency ablation for metastases in the liver or lung. A small probe inserted into the tumor emits microwaves or radio waves that heat the tissue, killing cancer cells. These are minimally invasive techniques, frequently performed as outpatient procedures.
  • Nanoknife Irreversible Electroporation (IRE), the newest ablation technology, sends high-voltage electricity into the tumor to kill cancer cells without injuring critical nearby blood vessels.
  • Selective Internal Radiation Therapy (SIRT) places tiny radioactive spheres or beads (using the isotope yttrium-90) into the artery that supplies blood to the liver tumor. The beads both block (embolize) the blood flow to the tumors and deliver radiation directly into them. SIRT is an effective option for patients whose liver metastases are inoperable.
  • Cytoreductive Surgery/Hyperthermic Intraperitoneal Chemotherapy (CS/HIPEC) is a highly specialized approach for abdominal metastases. Surgeons first remove all visible tumor, then bathe the abdominal cavity with heated chemotherapy drugs to kill any remaining microscopic cancer cells.
  • Stereotactic body radiation therapy (SBRT) is a radiotherapy approach in which radiation treatment is delivered in fewer, higher-intensity doses. SBRT uses advanced imaging with tumor tracking to target radiation with such precision that just a few treatment sessions (or a single session) are as effective for cancer control as weeks of traditional radiation therapy.
  • Video-assisted thoracoscopic surgery (VATS) is a minimally-invasive surgical approach to treat metastases to the lungs. Surgeons operate through two to four small incisions with the assistance of three-dimensional video guidance.