Defeating Stage IV Mucinous Colon Cancer: One Patient’s Resilient Battle

In January 2016, a 58-year-old female patient was referred to IUHW Shioya Hospital in Yaita, Japan, after receiving a diagnosis of descending colon cancer. Initial imaging revealed not only a tumor in her colon but also four small metastatic lesions in the right lung, measuring between 1×1 mm and 9×9 mm. These findings confirmed stage IV colon cancer.

The patient’s medical team first performed a partial resection of the descending colon. Pathological analysis showed a pT3N1M1 mucinous adenocarcinoma (stage IV). After five months of careful observation, no further metastases were detected, prompting a second surgery: partial right upper and lower lobectomies to remove the lung lesions. Unfortunately, two months later, a new 8×6 mm lesion appeared in the left lung. Her physicians chose to monitor the situation for six months to assess any additional spread. When scans confirmed that the new lesion remained the only source of active disease, a partial left lower lobectomy was undertaken to remove it.

To reduce the risk of recurrence, the patient underwent four months of CAPEOX chemotherapy, consisting of oxaliplatin (130 mg/m² on day 1) and capecitabine (1,000 mg/m² taken twice daily for two weeks). This amounted to seven treatment courses, after which ongoing neuralgia forced discontinuation of therapy. Remarkably, her cancer has not returned since her final surgery.

Over 2,212 days—more than six years—have passed without any signs of disease. She attends regular follow-up appointments every one to two months, where physicians track her progress through imaging and laboratory tests. This story highlights the power of combining decisive surgical interventions with targeted chemotherapy in managing advanced colon cancer. By acting quickly on new metastases and adapting the treatment strategy to address drug side effects, her care team successfully guided her to a lasting, disease-free survival.