Diagnosis
If colorectal cancer has been diagnosed, it is also important to find out if, where and how far the cancer has already spread in the body. There are various examinations available for this purpose. First of all, an ultrasound examination can be performed, especially of the liver.
Here the vessels and the structure of the liver are assessed and examined for changes. Lymph nodes in the abdominal cavity can also be examined and assessed by ultrasound. Furthermore, x-rays can be taken.
In particular, a thorax image is taken, i.e. an image of the chest. In this case special attention is paid to the lungs and possible changes. If the findings are unclear or questionable, a computer tomography (CT) can also be performed.
In this case, cross-sectional images of the body and thus of the organs are taken, which allow a reliable assessment. The brain and bones can also be assessed during a CT scan. Magnetic resonance imaging (MRI) can also be performed as a diagnostic tool for metastases.
In addition and depending on the location of metastases, tumour markers in the blood can also be determined. These include, for example, certain liver values. Further colonoscopies can also be performed to search for scattering in the intestine.
Therapy
The choice of therapy depends on the location and spread of the metastases and the presence or treated colorectal cancer. In general, surgical therapy is possible for lung metastases; the same applies to metastases in the liver. Here, the resection of liver segments is used to remove the metastases.
For example, if there are only a few metastases in the liver and if the colon cancer could also be operated on completely, the prognosis is quite good. The operation of lung and liver metastases depends on how much functional tissue would remain after the operation and that no metastases are already present in other organs. The underlying colon cancer should also be treated and the corresponding metastases in the lung or liver should be easily accessible for surgery.
If surgery is no longer possible due to the spread of the metastases, chemotherapy can alleviate the symptoms and thus improve the quality of life. It can also prolong life somewhat; this is known as palliative therapy. In the case of bone metastases, there is also a choice of different forms of therapy.
Radiation therapy, drug therapy or surgical options are available here. The choice of therapy depends on the spread of the metastases and the general state of health of the patient. In the case of brain metastases, the general alleviation of symptoms and the maintenance of quality of life are just as important as the actual therapy of the metastases.
Therapy is mainly concerned with the treatment of brain edema and the prevention of seizures. Corticosteroids (decongestant effect) as well as osmodiuretics (draining effect) can be considered. For seizures caused by brain metastases, the same drugs are used as for epilepsy (anticonvulsants).
