Colorectal Cancer, Metastatic or Recurrent

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This topic is about metastatic and recurrent colorectal cancer.

What is colorectal cancer?

Colorectal cancer happens when cells that are not normal grow in your colon or rectum Click here to see an illustration.. These cells grow together and form tumors. This cancer is also called colon cancer or rectal cancer.

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.

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 brain.

What causes metastatic or recurrent colorectal cancer?

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

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 returned or spread 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 remove polyps or 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?

Some colon and rectal cancers that have returned or spread can still be cured. Treatment may include surgery, radiation, and chemotherapy. When the cancer cannot be cured, treatment can help you feel better and live longer.

Learning that you have cancer can be upsetting. It may help to talk with your doctor or with other people who have had cancer. Your local American Cancer Society chapter can help you find a support group.

Frequently Asked Questions

Learning about metastatic and recurrent colorectal cancer:

Being diagnosed:

Getting treatment:

Ongoing concerns:

End-of-life issues:


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Author: Shannon Erstad, MBA/MPHLast Updated December 1, 2006
Medical Review: Adam Husney, MD - Family Medicine
Arvydas D. Vanagunas, MD - Gastroenterology

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