Where Does Colon Cancer Spread?

Metastatic cancer is a cancer that has spread from the original location -- like your colon -- to a different organ, such as the lung. If your cancer does spread to your lungs, the doctor will not refer to this new tumor as lung cancer, but rather colon cancer metastatic to the lung. Each type of cancer has a specific affinity for locations where it can potentially metastasize, or spread distally.

Although the potential exists for cancer to spread anywhere, metastatic colon cancer typically affects the liver, lung, and peritoneum -- or the lining inside the abdominal cavity. 

Detecting Metastasis

If your colon cancer was advanced at the time of diagnosis -- meaning that it was already through the wall of the colon, your doctor will check for metastasis to other sites, including the surrounding lymph nodes and organs. For metastasis to occur, the cancer has to travel somehow, which means that the cancerous cells can spread via your blood or your lymphatic system (lymph nodes). Colon cancer can also invade adjacent organs locally, but this is not considered metastasis. The three most common sites of colon cancer metastasis include the:

Your doctor will consider your physical symptoms as well as the stage of your colon cancer prior to deciding what tests to order.

Paired with an advanced cancer diagnosis, some symptoms might suggest the possibility of metastasis including:

  • Unexplained weight loss
  • Shortness of breath and a chronic cough
  • Abdominal pain or visible masses on your abdomen
  • Increasing fatigue
  • Yellowing of the skin or eyes

However, exhibiting symptoms of metastasis is usually an indication that the masses in the new organ are already large enough to be causing problems.

Prior to showing signs of metastatic cancer, an x-ray or CT scan can check for metastasis to the lungs, perineum, or liver. Ultrasounds and blood tests can also be used to check the perineum and liver. Positron emission tomography (PET) scans can also detect the presence of masses or tumors in your body, but are not typically the first test ordered. If a lesion or suspicious mass is found on a scan, your doctor will order a biopsy to test the tissue.

Testing the Tumor Cells

Many solid tumors can be tested using a fine needle biopsy procedure. If there is a mass found on your liver or in your lung, the doctor insert a needle through your skin and into the tumor to extract tiny portions of tissue for testing. This tissue will be immediately sent to the pathologist for testing. The pathologist will then determine if the cells are from your colon cancer, or from a new cancer, which will impact your treatment choices moving forward.

If you are not a candidate for a fine needle biopsy, your doctor might suggest an open biopsy.

You will be put under general anesthesia for this procedure but should still be able to go home on the same day. Likewise, your surgeon might take tissue samples if your have bowel surgery to treat your colon cancer, and can check organs near your bowel for potential metastatic disease at that time. 

Although most cancer survivors have a fear of recurrence, the chances of developing a new primary cancer is very low. For instance, if you have stage III or IV colon cancer and develop a new mass in your liver, there is a very good chance that it is a metastatic tumor from your colon. Unfortunately, metastases typically heralds advancing disease and can significantly decrease -- not eliminate -- the likelihood of a cure.

Talk to your doctor about your specific chance of developing a metastatic tumor. He or she can factor in your prior history and stage of cancer along with the percentage of people similar to you who have been diagnosed with metastatic cancer. 


American Cancer Society. (n.d.) Unlocking the Mysteries of Metastasis. Accessed online March 29, 2015.

Grundmann, R.T., Meyer, F. (December 2012). Second Primary Malignancy Among Cancer Survivors - Epidemiology, Prognosis and Clinical Relevance. Accessed online March 29, 2015 via PubMed.

National Cancer Institute. (n.d.). Metastatic Cancer. Accessed online March 28, 2015.

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