Researchers found that most patients with metastatic colorectal cancer (cancer that has spread outside of the colon or rectum) do not need surgery to remove the primary tumor unless it is causing problems. Removing the primary tumor when a person is diagnosed with metastatic colorectal cancer was once the standard treatment and is still common. Surgery has been used to prevent the tumor from blocking the intestines, creating a hole in the wall of the intestine, or causing bleeding. Chemotherapy is an effective treatment for metastatic colorectal cancer because it can often shrink both the primary tumor and the cancer that has spread to other areas.
This study looked at patients who received chemotherapy for metastatic colorectal cancer between 2000 and 2006 but did not need immediate surgery. According to the researchers, 93% of the patients never developed problems that required surgery to remove the primary tumor. For the 7% who did eventually need surgery, most did not have any problems caused by surgery.
What this means for patients
“In this era of modern chemotherapy, surgery to remove the primary tumor for patients with metastatic colorectal cancer may not be needed,” said lead author Philip Paty, MD, Attending Surgeon and Vice Chairman of Clinical Research at Memorial Sloan-Kettering Cancer Center in New York City. “In addition to being an unnecessary procedure that has risks, surgery delays the start of chemotherapy by at least four to six weeks. Unless there is an immediate need for surgery, patients should begin chemotherapy first.”
What to Ask Your Doctor
- What stage is my colorectal cancer? Has it spread to other parts of the body?
- What are my treatment options?
- Will I need surgery?
- What treatment do you recommend? Why?
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