Despite better screening for colorectal cancer (CRC), about 1 in 5 newly diagnosed patients will have metastatic CRC that already has spread to distant organs. Many will have symptoms of fatigue or weight loss, but only a minority will have symptoms (significant bleeding or abdominal pain, or a blocked bowel) caused by the colon tumor itself.
In those people first diagnosed with stage IV CRC, about 80% have metastases that cannot be removed by surgery. There’s been intense debate—but no clear evidence—about whether patients whose colon tumor isn’t causing symptoms should have the colon tumor surgically removed routinely before they start chemotherapy.
A recent important study provides the first evidence that such patients often do just as well to start systemic chemotherapy immediately without having their colon tumor surgically removed. Read the rest of this entry »