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Overview The colon and rectum are parts of the body's digestive system and together form a long, muscular tube called the large intestine. The colon is the first 6 feet of the large intestine and the rectum is the last 8-10 inches. Treatment approaches differ between cancers of the colon or rectum and are ,therefore, discussed separately. A separate section has been created for Rectal Cancer. Adenocarcinoma that begins in the cells that line the colon or large intestine accounts for over 90%-95% of cancers originating in the colon. Other cancers, including carcinoid and leiomyosarcoma, also originate in the colon but are not referred to as colon cancer. This treatment overview deals only with adenocarcinoma of the colon, which will be referred to as colon cancer. The treatment of colon cancer may involve several physicians, including a gastroenterologist, a surgeon, a medical oncologist, and other specialists. Care must be carefully coordinated between the various treating physicians involved in management of your cancer. In order to understand the best treatment options available for treatment of colon cancer, you must first determine where the cancer has spread in the body. The initial spread of colon cancer occurs circumferentially around the colon like a "napkin ring" before invading adjacent organs and spreading through the lymph and blood systems. Colon cancer cells may spread via the blood throughout the body to the liver, lungs, and other organs. Determining the extent of the spread or the stage of the cancer requires a number of tests and is ultimately confirmed by surgical removal of the cancer and exploration of the abdominal cavity. Computerized Tomography/Magnetic Resonance Imagery (CT/MRI) scans of the chest, abdomen, and pelvis are used to determine where the cancer has spread. Additional colon cancers are present in 3%-5% of patients, and colonoscopy may be used to identify whether a second cancer is present in the colon prior to surgery . Adjuvant chemotherapy after surgery is used to prevent recurrences in patients with apparent localized cancer of the colon (stage I-III). However, current staging techniques do not predict accurately those patients destined to relapse in the liver without adjuvant treatment or those who do not need additional treatment after surgery. A new technique, Doppler ultrasound, can be used to assist in predicting subsequent liver metastases in patients with cancer of the colon or rectum who only received surgery. One study showed that the Doppler perfusion index more accurately predicted outcomes following surgery than did the stage of cancer as determined by standard tests. Upon completion of the clinical "staging evaluation", surgery is performed to remove the cancer with part of the normal adjacent colon (hemi-colectomy) and determine the level of spread within the colon and abdomen. Surgery is performed through an abdominal incision and more recently through a laparoscope. Laparoscopic hemi-colectomy may be associated with faster healing than traditional surgery and is currently being evaluated in clinical trials. Following surgical removal of colon cancer and examination of removed tissue under a microscope, a final "pathologic" stage will be given. This may be a letter or a number, as several different staging systems are used to describe colon cancer. All new treatment information concerning colon cancer is categorized and discussed by the stage. In order to learn more about the most recent information available concerning the treatment of colon cancer, click on the stage for which you are interested. Stage I or A-B1: Cancer is confined to the lining of the colon. Stage II or B2-3: Cancer may penetrate the wall of the colon into the abdominal cavity or other adjacent organs but does not invade any local lymph nodes. Stage III or C1-3: Cancer invades one or more of the local lymph nodes but has not spread to other distant organs. Stage IV or D: Cancer has spread to distant locations in the body, which may include the liver, lungs, bones, or other sites. Recurrent/Relapsed: Colon cancer has progressed or returned (recurred/relapsed) following an initial treatment.
USED WITH PERMISSION OF CANCERCONSULTANTS.COM copyright® 1998, last updated 7/00, CancerConsultants.com - All Rights Reserved. "The information contained above is general in nature and is not intended as a guide to self-medication by consumers or meant to substitute for advice provided by your own physician or other medical professional. The reader is advised to consult with a physician or other medical professional and to check product information (including packaging inserts) for changes and new information regarding dosage, precautions, and contra indication before administering any drug, herb, supplement, compound, therapy or treatment discussed herein. Neither the editors nor the publisher accepts any responsibility for the accuracy of the information or consequences from the use or misuse of the information contained herein." |
