A diagnosis of metastatic colorectal cancer can bring a flood of information, decisions, and questions. For many patients and families, the first appointment can feel like too much to process all at once.
In a recent discussion with USC Norris Comprehensive Cancer Center medical oncologist Dr. Heinz-Josef Lenz, we walk through what patients can expect after a diagnosis.
The first weeks are about gathering information
Before your oncology team recommends a treatment plan, they may need to learn more about both the cancer and your overall health. There’s a lot of information to cover, but Dr. Lenz emphasizes that “we will work through every single step.”
This can include:
- Imaging scans to determine where the cancer has spread
- Blood tests and other laboratory work
- Molecular or genetic testing of the tumor
- Biomarker testing
- Discussions about your overall health and other medical conditions
- Planning for treatment, including whether you may need a port
Dr. Lenz notes that understanding the cancer’s molecular characteristics is particularly important early in the process. “The genetic testing needs to be right away to not lose time,” he said.
Your care team will also want to understand where the cancer has spread and how extensive it is. For example, they may look at whether metastases are located in one organ or multiple organs and whether there is one lesion or several.
These details can help shape the goals of treatment.
Metastatic doesn’t always mean the same thing for every patient
One of the most important points Dr. Lenz discussed is that metastatic colorectal cancer isn’t identical from one person to another.
“Many patients have a chance to be cured, even if they’re told they are not,” he says, explaining that treatment possibilities can depend on where the cancer has spread and how many lesions are present.
He adds, “Having liver and lung lesions does not mean you’re not curable. It depends where the lesions are and how many, not necessarily the number of organs.”
Not every patient with metastatic colorectal cancer will have the same treatment goals, and not everyone will be a candidate for treatments intended to eliminate all visible cancer. That’s why the details of your individual diagnosis matter.
You don’t have to remember everything
It’s normal to leave an appointment and suddenly remember five questions you meant to ask.
Dr. Lenz encourages patients not to panic if they cannot absorb every piece of information immediately. “They don’t need to be getting desperate because they didn’t ask all their questions and information is not clear,” he said.
Instead, write questions down as they come up. Bring a family member or friend to appointments if possible. Ask your care team whether you can take notes or record important discussions. And remember that treatment planning is often a process that unfolds over several appointments.
Dr. Lenz shares that the goal is to help patients get to a place where they feel more comfortable knowing that “they will get the information over the next couple of weeks.”
Understanding your cancer, completing recommended testing, and talking through your options with your care team can help you take the next steps one at a time.
Watch the full discussion with Dr. Lenz here.
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