Symptoms depend on where the metastases are located. Bowel cancers typically spread to the liver and lungs, showing little symptoms for a long time. Sometimes bowel cancer also spreads to the abdominal cavity, bones, or other internal organs. Rectal cancer may recur locally in the pelvic area. Read on for more information about the most common symptoms caused by metastases.
Symptoms related to metastases in the lungs and liver
Individual metastases in the lungs and liver usually don’t cause many symptoms, meaning that metastatic bowel cancer may be fairly quiet in terms of symptoms. Individual metastases in the liver and lungs can be treated locally with surgery, and in the case of lung metastases, with radiation therapy; the aim is to slow down the cancer’s progression. If metastases in the lungs are causing shortness of breath or coughing, the symptoms may be relieved with medicines or radiation therapy. If there is a build-up of fluid around the lungs, the fluid can be removed with a needle.
In many cases, liver metastases don’t cause symptoms until there is a large number of them and liver function starts to suffer. A common symptom experienced at this point is increasing fatigue. Corticosteroid medicines may be helpful.
Bone pain and other symptoms related to bone metastases
In bowel cancer, bone metastases usually appear as individual cases, most commonly in the spine. In terms of symptoms, they cause pain that gets worse when moving. Both pain medicines and radiation therapy are effective. Bone metastases can also cause fractures, and metastases in the spine can press on the spinal cord. In such cases, acute medical treatment is required.
Bowel function problems
It’s possible for cancer to spread to the abdominal cavity and disrupt bowel function. Sometimes a tumour or cancer that’s spread to the abdominal cavity leads to bowel obstruction, which may require surgical treatment. Symptoms of bowel obstruction include constipation, nausea, vomiting, and stomach pain. Bowel obstruction requires acute medical attention (contact the unit responsible for your care or visit the emergency department); in the case of advanced cancer, symptoms of bowel obstruction can also be relieved with medication.
Build-up of fluid in the abdomen
It’s also possible for a build-up of fluid to develop in the abdominal cavity, causing the belly to swell and become bloated. The excess fluid can be removed with a needle or through a drainage catheter, which rapidly relieves the symptoms.
Symptoms caused by tumours in the pelvic area
If rectal cancer spreads to the pelvic area, it may cause pain and difficulty urinating or problems with passing stools. Sometimes a tumour forms an opening (also called a “fistula”) between organs or through the skin (for example, between the bladder and the bowel, between the bowel and the vagina or through the skin). A tumour can cause tissue damage and nerve compression in the pelvic area, resulting in pain. Symptoms caused by tumours may be relieved with radiation therapy, and sometimes with surgical operations like by creating a stoma (an artificial opening). In the case of severe pain, special techniques such as spinal pain management may be used. This involves inserting a catheter to administer pain medicine and numbing anaesthetics into the space around the spinal cord containing cerebrospinal fluid. This treatment can also take place at home.
Psychological strain
Having an illness puts strain on the mind too. Living with a long-term illness includes both good and bad moments. It’s good to talk to the care team about how you’re coping mentally. Depression and anxiety can be managed both by talking and with medication. Peer support may also be helpful.
