RN Nursing · Pathophysiology · Practice question
A client who had surgery for colon cancer last year received a report today that cancer has returned and has metastasized. What finding supports this report?
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Cancer in the colon is very large and will require extensive surgery.
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The cancer was stage II when surgery was performed, but it is now diagnosed as stage IV.
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Testing shows that the cancer is in one area of the colon.
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✓
A computed tomography (CT) scan shows that the cancer is on the client's liver.
Answer & explanation
Correct: A computed tomography (CT) scan shows that the cancer is on the client's liver.
Metastasis is the process by which cancer cells spread from the primary tumor site to distant organs or tissues through the blood or lymphatic system, establishing secondary tumors. A CT scan showing cancer on the liver in a client who previously had colon cancer is the clearest evidence of metastasis, because the liver is a common distant site for colorectal cancer spread via the portal circulation. Option 407122 describes local tumor size, which indicates growth at the primary site but does not confirm spread to a new location. Option 407123 describes a change in staging, which can reflect either local growth or distant spread, but staging alone does not specifically confirm metastasis without location data; however, stage IV does imply distant metastasis, making this option plausible but less specific than option 407125. Option 407124 directly contradicts metastasis by stating the cancer is contained in one area. The liver finding on CT is the most direct and concrete evidence of metastatic disease because it demonstrates cancer cells have traveled from the colon and formed a new tumor in a distant organ.
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