Symptoms of final stage colon cancer can vary, and they typically depend on the areas of the body affected by the cancer. Abdominal pain or other gastrointestinal symptoms are common. They may arise from the cancer itself, scarring from previous radiation or surgery, medications or palliative chemotherapy. As the disease progresses, pain may become prominent, and a poor appetite, weight loss, weakness and fatigue are typically present. The focus of treatment in the final stage will be on palliation, aimed at maintaining the quality of life, as well as minimizing symptoms.
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Colon cancer in its advanced stage can cause blockage of the intestine if the tumor has recurred or has not been completely removed by surgery. Changes in bowel habits, such as constipation, diarrhea or difficulty passing stool, will often ensue. Blood in the stool may also be noted. If the blockage is severe, complete bowel obstruction can occur. This will cause a distended abdomen, as well as prominent abdominal pain, nausea and vomiting.
Palliative Chemotherapy Effects
With advanced colon cancer, chemotherapy is sometimes given palliatively. Such therapy may help reduce the rate of tumor progression, but it also has the potential to cause symptoms such as severe diarrhea, weakness, dizziness and even fainting. Certain types of chemotherapy may result in mucositis -- inflammation and open sores in the mouth -- or numbness and tingling, typically in the fingers and toes. Reduced immune function due to low white blood cell counts -- often referred to as leukopenia or neutropenia -- can result in unexplained fevers and a wide variety of infections.
Anorexia and Weight loss
Advanced colon cancer and its treatment often lead to a loss of appetite, known as anorexia. This may result in significant weight loss. Some people may have noticeable thinness, with loss of muscle and fat, which can lead to pressure sores over bony areas. Nutritional supplementation and increasing food intake can be used to try to lessen the degree of weight loss.
Advanced colon cancer can spread to the bone, where it may cause pain and fractures. These may be treated with radiation to the bone or surgery. Fatigue and shortness of breath can be prominent because of the cancer or pain medication. Confusion or other changes in thinking may arise due to the side effects of medications, cancer entering the brain or the effects of poor hydration and nutrition. As the disease enters its final stage, taking in any type of food or drink often becomes a major problem. Efforts are directed at providing supportive comfort care during this time.
- The Merck Manual Professional Edition: Cachexia in Cancer
- National Library of Medicine at the National Institute of Health: Palliative Chemotherapy for Advanced Colorectal Cancer: Systematic Review and Meta-analysis
- National Library of Medicine: National Institute of Health: ABC of Colorectal Cancer: Treatment of Advanced Disease
- National Cancer Institute at the National Institute of Health: Last Days of Life