Rectal cancer metastasis occurs when cancer cells spread from the primary tumor in the rectum to other organs. The liver is the most common site for stage 4 rectal cancer metastasis, significantly increasing mortality risk.

Currently, no specific measure completely prevents rectal cancer from spreading to the liver, as this process involves the biological characteristics of cancer cells, the immune system, and the portal venous circulation structure. However, a healthy lifestyle, regular screening, and adherence to post-treatment follow-up can reduce the risk of gastrointestinal cancer and lower the chance of liver metastasis.

Maintaining a healthy diet is crucial. Drink enough water and increase fiber intake from green vegetables, fresh fruits, and whole grains to improve bowel movement and reduce the absorption of carcinogens. Supplement with high-quality protein from fish, lean meat, soy, and eggs to maintain immune resistance. Limit saturated fats, fried foods, and processed red meats, such as sausages and bacon, as they may contain substances that can cause cancer.

Avoiding risk factors is also essential. Tobacco contains nicotine and oxidizing agents that can cause gene mutations, promoting the formation of cancer cells. Alcohol and alcoholic beverages damage liver cells, creating conditions for cancer cells to develop and metastasize.

Maintain a healthy weight, and lose weight if obese, as visceral fat can cause chronic inflammation and metabolic disorders, increasing cancer risk. Maintain an active lifestyle, exercising at least 150 minutes each week. Activities can include brisk walking, swimming, or yoga.

A doctor advises a rectal cancer patient. *Photo: Tam Anh General Hospital*

Ensure sufficient sleep and avoid prolonged stress, as nervous tension can affect the immune and endocrine systems, potentially accelerating disease progression. It is important to control co-existing chronic conditions such as diabetes, hepatitis, and fatty liver, as these factors can reduce the liver's resistance.

Adults over 40 years old or those with risk factors, such as a family history, colon polyps, or chronic ulcerative colitis, should undergo cancer screening one to two times each year. Doctors may recommend methods like colonoscopy to detect and remove pre-cancerous polyps, fecal occult blood tests (FOBT, FIT), gene mutation or DNA tests in stool (ColoGuard, Oncocare), and regular liver ultrasound or computed tomography (CT) scans after treatment to detect early metastasis.

Follow-up appointments are crucial: every three to six months for the first three years, then every six to twelve months thereafter. Doctors will monitor serum CEA levels and conduct regular liver CT or MRI scans to detect early liver metastasis. Patients must adhere to the prescribed treatment and follow-up schedule, avoiding self-discontinuation of medication or use of alternative herbal remedies without specialized medical consultation.

Associate Professor, Doctor Ngo Thi Tinh

Department of Oncology

Tam Anh General Hospital Hanoi