Metastatic colorectal cancer (stage 4)

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was reviewed on April 13, 2022.

Cancer cells may break away from a tumor in the colon or rectum and spread to other parts of the body through the bloodstream or lymphatic system. These cells may settle and form new tumors on a different organ. Even though the cancer has spread to a new organ, it is still named after the part of the body where it originally started. So colorectal cancer that spreads, or metastasizes, to the lungs, liver or any other organ is called metastatic colorectal cancer or stage 4 colorectal cancer.

The most common site of metastases for colorectal cancer, which includes colon cancer or rectal cancer is the liver. Colorectal cancer cells may also spread to the lungs, bones, brain or spinal cord. If you have been treated for colorectal cancer and cancer cells have been found in these areas, it may be a sign that the original colorectal cancer has spread. Metastatic colorectal cancer is different from recurrent colorectal cancer. Recurrent colorectal cancer is cancer that returns to the same part of the colon or rectum after treatment, rather than spreading to other parts of the body.

Treatment options for metastatic or stage 4 colorectal cancer

Treatment options may vary depending on where the cancer has spread, but they may include surgeryradiation therapychemotherapy and/or targeted therapy.

Treatment for stage 4 colorectal cancer

Since the colon and rectum are so close to the liver, the liver is the most common site for colorectal cancer to spread.

While treatments for such cases are not generally considered curative, they may help improve your quality of life. If your cancer has spread to the liver, the most commonly used treatment options include the following:


If the cancer has only spread to a small area of the liver, it can sometimes be removed surgically. Often, the liver tumor can be extracted at the same time as the colon cancer.


Chemotherapy is used when the liver tumor is too large to be removed surgically. Your care team will let you know exactly which chemotherapy drugs are appropriate for your cancer type. In some cases, a pump is inserted inside the body that delivers chemotherapy directly to the liver tumor. This is known as hepatic artery infusion.

Targeted therapies

Targeted therapies may be used in conjunction with chemotherapy or on their own. Like chemotherapy, targeted therapy drugs also enter the body via the bloodstream, but can more specifically target proteins and genes that are involved with the growth of cancer cells.

Ablation and embolization

Metastatic colorectal cancer in the liver can also be treated through ablation or embolization. Radiofrequency ablation (RFA) uses high-frequency radio waves to kill cancer cells. With embolization, your doctor injects a substance straight into the artery in the liver to halt or greatly reduce its blood flow.


If applicable to the genetic makeup of your cancer type, immunotherapy for colorectal cancer may be an option. This treatment involves a medication that helps your body’s immune system identify and destroy cancer cells.

Clinical trials

Researchers are constantly working on ways to improve treatments for patients with metastatic or stage 4 colorectal cancer in the liver. For example, liver transplants are starting to be used. While only a few procedures have been done so far, it’s possible that liver transplants for metastatic colon cancer could become a common treatment in the future.

To learn about newer treatment options being tested, speak with your care team about clinical trials. These may present opportunities to receive brand-new medical treatments and the highest possible quality of care, while also contributing to medical research.

Metastatic (stage 4) colorectal cancer survival rate

If you have stage 4 colorectal cancer, your life expectancy will vary based on a number of factors, including your cancer type.

Colorectal cancer can be localized, which means it’s contained within the rectum or colon; or it can be metastatic, meaning it has spread to other parts of the body. If it has reached nearby parts, it’s known as regional cancer. If the spread is farther way, it’s known as distant cancer.

Stage 4 colon cancer survival rate

The average five-year survival rate for metastatic colon cancer is 72 percent for regional and 14 percent for distant cancer, according to the American Cancer Society.

Stage 4 rectal cancer survival rate

If you have metastatic rectal cancer, the five-year survival rate estimate is 73 percent for regional cancer and 17 percent for distant cancer.

As treatment options improve, so do survival rates. Everyone’s circumstances are unique, so be sure to discuss your specific situation with your care team.

Next topic: What are the stages of colorectal cancer?

Expert cancer care

is one call away.
appointments in as little as 24 hrs.