Colorectal Cancer: The Shadow of Metastasis Behind the 'Good Cancer' Myth

Colorectal cancer, often dubbed a "good cancer," carries a dangerous misconception that it is easily treatable and curable, largely due to high success rates in early detection and surgery. However, this view dangerously downplays the significant challenges posed by its frequent recurrence and metastasis, leaving many patients struggling with inadequate treatment options.

"Aren't colorectal cancers 'good cancers' that can be cured with surgery?" This question reflects a widespread misunderstanding fueled by advancements in national cancer screening and colonoscopy. While it's true that many early-stage cases are successfully treated, this overlooks the critical reality that a substantial portion of patients, estimated between 50-60%, will experience recurrence or metastasis during their treatment. The cancer's tendency to spread to the liver, lungs, or peritoneum makes long-term management essential, yet the available treatment landscape in South Korea is proving insufficient.

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Patients and their guardians often tell me in the clinic, 'There are no more drugs to use,' but strictly speaking, it's not that there are no drugs, but that there are no drugs covered by insurance.

Dr. Lee Myung-ah, a professor of oncology at Seoul St. Mary's Hospital, highlights the gap between patient needs and current treatment accessibility. "Patients and their guardians often tell me in the clinic, 'There are no more drugs to use,' but strictly speaking, it's not that there are no drugs, but that there are no drugs covered by insurance," she explained. This limitation restricts treatment choices, especially for patients with advanced or recurrent disease, who require a diverse range of therapies to manage their condition and maintain quality of life.

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Colorectal cancer is a cancer related to obesity, diet, and very closely related to high cholesterol levels.

While colorectal cancer can be aggressive, particularly in younger patients whose cancers may progress faster, it also possesses unique characteristics that offer hope. Unlike many other solid tumors, even stage 4 metastatic cancer can potentially be cured if surgically resectable, with 5-year survival rates reaching around 20%. Furthermore, many patients maintain a relatively good overall health status, allowing them to continue working and engaging in social activities even during long-term treatment. The challenge lies in ensuring they have access to the necessary treatments to achieve these outcomes.

The article underscores the critical need to shift the narrative surrounding colorectal cancer. It's not just about early detection; it's about establishing a robust long-term treatment environment that supports patients through recurrence and metastasis. This includes improving access to a wider array of anti-cancer drugs and therapies, ensuring that patients, especially younger ones with potentially faster-progressing disease, have the best possible chance to manage their condition and live fulfilling lives.

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Even with stage 4 metastatic cancer, if the visible lesions are confined to the colon and liver or lungs, and surgical resection is possible, a treatment strategy aiming for a cure can be actively considered.