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Colorectal cancer is one of the top three cancers worldwide. In Singapore, it is the most common cancer among men and second only to breast cancer among women. While most patients with colorectal cancer are diagnosed at an early or locally advanced stage, others present with relapsed and/or advanced cancer.

Different types of treatment are available for patients with advanced colorectal cancer. The main treatment for patients with advanced colorectal cancer is with medicines, namely chemotherapy, targeted therapy and immunotherapy. Chemotherapy aims to kill cancer cells by interfering with their ability to divide, while targeted therapy attacks cancer by interfering with molecules involved in cancer growth and spread. Cancer immunotherapy uses a patient’s immune system to fight cancer. Due to advancements in medical science, doctors are now able to analyse cancer cells in order to select suitable targeted therapies and to predict the likelihood of immunotherapy working on the individual patient.

Surgery may be considered in certain situations in patients with advanced colorectal cancer. For example, surgery may be needed to relieve intestinal obstruction or intestinal bleeding that is difficult to control by other non-surgical methods. In a selected group of patients where the spread of colorectal cancer is limited to the liver, aggressive surgery to remove the primary cancer and affected area or areas of the liver may still offer the prospect of cure.

Like surgery, radiotherapy may also be considered in certain situations in patients with advanced colorectal cancer. For example, radiotherapy may be needed to control a painful area of bone spread or bleeding from a rectal primary.

Doctors may combine different treatments for greater effect, taking into account other factors like the patient's symptoms and overall health. The survival rate of advanced colorectal cancer has seen an overall increasing trend over the years, largely reflective of the improvements in treatment methods. Even when cancer cannot be cured, appropriate and individualised treatment that takes into account patient- and cancer-related factors may still allow for effective control of symptoms and meaningful prolongation of life.