Hello Everyone! I’m Dr Praveen Kammar, a Cancer Surgeon specializing in digestive system and gynecological cancers. In today’s video, we’ll discuss how Stage 4 colon or rectal cancer spreads to the liver and what that means for the patient.

What Is Stage 4 Colon or Rectal Cancer?
Stage 4 cancer means that the disease has spread from its original site (colon or rectum) to other organs, and the liver is the most common organ where it spreads. When we evaluate colon or rectal cancer, we find that 15-25% of patients already have liver metastasis at the time of diagnosis. Even in patients successfully treated for colon or rectal cancer, 7-30% may later develop liver metastasis during follow-up.

How Does Cancer Spread to the Liver?
Cancer cells spread to the liver through the bloodstream in a process called hematogenous metastasis. The liver, although only 2.5% of the body’s weight, receives 25% of the blood flow from the heart. This means that cancer cells circulating in the blood from the colon or rectum pass through the liver multiple times, and the liver provides an ideal environment for cancer cells to settle and grow.

The Spectrum of Stage 4 Cancer
Stage 4 colon or rectal cancer is not the same for all patients. A small 1 cm deposit in the liver is considered Stage 4, but so is the presence of hundreds of deposits across both lobes of the liver. The treatment approach and prognosis depend on the extent of the spread, the size and number of liver metastases, and whether the cancer has spread to other organs.

Why the Liver?
The liver offers a favorable environment for cancer cells because it supplies nutrients and has plenty of blood flow. Cancer cells can thrive in this environment and begin to multiply, leading to metastasis. However, the liver is often not the only site of spread—other organs like the lungs or distant lymph nodes may also be affected.


Video Flow:
Correct Video Flow:
0:00 Introduction by Dr. Praveen Kammar
0:05 Overview of how Stage 4 colon or rectal cancer spreads to the liver
0:37 Explanation of liver metastasis and its frequency in Stage 4 cancer
1:00 Discussion of hematogenous metastasis (bloodstream spread)
1:45 How the liver acts as a favorable environment for cancer spread
2:19 Discussion on cancer spreading beyond the liver (other organs like lungs)
4:00 Importance of evaluating the whole body for metastasis
4:30 Summary of key points
4:45 Conclusion
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