Metastatic colorectal cancer means the cancer that began in the colon or rectum has spread to other parts of the body, most often the liver or lungs. It’s considered stage IV and is typically treated with combinations of chemotherapy, targeted therapy, and immunotherapy to control the disease and improve quality of life. Many clinical trials are underway testing new drug combinations, immunotherapies, and precision treatments based on tumor genetics. These studies aim to discover more effective and less toxic options for people living with advanced colorectal cancer.

Stage IV colorectal cancer means the disease has spread beyond the colon or rectum to distant organs, most often the liver, lungs, or peritoneum. At this stage, the goal of treatment is usually to control the cancer, relieve symptoms, and extend survival rather than cure it, though in some cases surgery or localized treatments can remove limited metastases. Treatment often includes chemotherapy, targeted therapy, or immunotherapy, depending on the tumor’s genetic makeup.

There are many clinical trials for stage IV colorectal cancer exploring new drug combinations, immune-based therapies, and personalized treatment approaches based on biomarkers like KRAS, BRAF, or MSI-H status. These studies aim to find more effective options for patients whose cancer has spread or stopped responding to standard treatments.

Yes — many people have survived stage 4 colorectal cancer, especially in recent years as treatments have improved. While it’s considered an advanced stage, outcomes can vary widely depending on where the cancer has spread, how it responds to treatment, and the patient’s overall health and genetics.

Some patients whose cancer has only spread to the liver or lungs can even undergo surgery or localized treatments to remove those metastases and achieve long-term remission or cure. Others benefit from modern chemotherapy, targeted therapies, and immunotherapies, which can keep the cancer under control for years.

With today’s advances — including biomarker-guided treatments and immunotherapy — long-term survival and even complete remission are increasingly possible for select stage 4 colorectal cancer patients.

The 3-2-1 rule for colon cancer is a simple way to remember potential warning signs that should prompt early screening or medical evaluation, especially for people at higher risk or with a family history of colorectal cancer. It stands for:

• 3 relatives with colon cancer (or related cancers such as endometrial, ovarian, or stomach cancer),

• 2 generations affected, and

• 1 person diagnosed before age 50.

If your family history fits this pattern, it could suggest an inherited condition like Lynch syndrome, which increases the risk of colorectal and other cancers. People meeting the 3-2-1 rule are encouraged to speak with their doctor about genetic testing and earlier, more frequent colon screenings.

In 2025, major breakthroughs in colon cancer treatment are transforming how the disease is managed. The FDA approved a new targeted combination of sotorasib and panitumumab for patients with KRAS G12C–mutated metastatic colorectal cancer, offering new hope for those with advanced disease. Immunotherapy combinations such as nivolumab plus ipilimumab have also shown significant survival benefits for patients with MSI-H/dMMR tumors. Researchers in 2025 are advancing personalized therapies, exercise-based recovery programs, and early detection methods, marking a new era of more precise and effective colon cancer care.

Colonoscopies are not routinely recommended after age 75 because, for most people, the risks begin to outweigh the benefits at that age. Here’s why:

• Slower-growing cancers: Colon cancer typically develops slowly, often over 10–15 years. By the late 70s, the chance of detecting a cancer that would cause serious harm in a person’s remaining lifetime is lower.

• Procedure risks: Colonoscopy carries small but real risks—such as bleeding, perforation of the colon, or complications from anesthesia—that increase with age and other medical conditions.

• Individualized benefit: After 75, decisions are based on a person’s overall health, life expectancy, and prior screening history. Someone who’s healthy and never had a colonoscopy might still benefit, while someone with multiple prior normal screenings or serious health issues might not.

In short, colonoscopies after 75 aren’t automatically ruled out—they’re just considered case by case to ensure the potential benefit outweighs the risk.