Late-Stage Colon Cancer: New Local Treatment Options & Liver Metastasis

Colorectal cancer ranks as the third most common cancer in Hong Kong. In advanced cases, cancer cells metastasize to other organs, increasing the difficulty of treatment. Clinical oncologist Dr. Lam Ka On states that liver metastasis is common in colorectal cancer, and various targeted treatment options are currently available. Patients who receive systemic treatment, such as targeted therapy, generally respond well, and can then consider appropriate local therapies based on their condition, such as a new “Histotripsy” technique introduced in recent years, which kills cancer cells and helps improve the chances of a cure.

According to the latest data from the Hong Kong Cancer Registry, colorectal cancer was the third most common cancer in Hong Kong in 2023, with 5,467 new cases. Among these, 23.9% were in the fourth stage, indicating that the cancer had spread. In the same year, more than 2,000 people died from colorectal cancer.

Late-Stage Colorectal Cancer: Surgery Alone Is Often Insufficient

Colorectal cancer commonly metastasizes to the lymph nodes and liver, followed by the abdominal cavity. Dr. Lam explains that when the disease reaches an advanced stage, patients often worry about being “untreatable” or want to undergo surgery as quickly as possible in the hope of completely eliminating the tumor. However, since the cancer has already spread, This proves difficult to remove it completely with surgery alone. In these cases, systemic treatment is recommended first, and then a local treatment plan is determined based on the effectiveness.

Systemic treatment includes chemotherapy, targeted therapy, or immunotherapy. Patients demand to undergo genetic and cancer marker testing related to colorectal cancer, such as whether there is a RAS gene mutation or a HER2 gene mutation, to match the corresponding drug therapy. If systemic treatment is effective, the disease does not worsen, and there are no intolerable side effects, clinicians can then consider local treatment options.

Histotripsy Can Treat Liver Metastasis

In terms of local treatment, traditional treatments include stereotactic radiotherapy, radiofrequency ablation, microwave ablation, cryotherapy, and more. A new method introduced in recent years, Histotripsy, uses high-frequency ultrasound to rapidly expand and contract tissue, creating microbubbles that shock and destroy cancer cells. The benefit is that patients do not need to undergo invasive procedures such as surgery, needle insertion, or radiofrequency ablation. It is particularly suitable for patients with a small number of metastases and solid response to systemic treatment.

However, this technique also has limitations. For example, patients need to be suitable for general anesthesia, and the tumor must be detectable when using ultrasound technology before the treatment can be performed. Some of the surrounding liver cells may be damaged during the treatment.

Dr. Lam emphasizes that with the rapid development of medical technology, new therapies for advanced cancer are constantly emerging, bringing hope for a cure to colorectal cancer patients. Patients should face their condition with optimism. He also reminds the public to participate in the government’s colorectal cancer screening program (suitable for people aged 50 to 75 without colorectal cancer symptoms) to detect and remove polyps early, reducing the risk of developing colorectal cancer in the future. If you experience any suspected colorectal cancer symptoms, such as blood in the stool or changes in bowel habits, seek medical attention promptly.

Dr. Lam concludes by reminding that there are different treatment options for colorectal cancer, each with its effectiveness and side effects. Patients should discuss with their attending physician to choose the most appropriate treatment plan.