Colon cancer stages
Colon cancer has 4 stages. In stage 1 cancer has invaded into, but not through, the entire wall of the intestine. In stage 4 cancer has spread or “metastasized” to distant organs, such as the liver or lungs.
Treatment depends on the disease stage. Earlier stages of disease (stages 1 through 3) are referred to as localized colon cancer and are generally treated with surgery, with or without chemotherapy. Stage 4 cancer is called advanced colon cancer and is generally treated with chemotherapy; some patients may benefit from surgery of the primary tumor before treatment of metastatic disease, especially if the primary tumor is causing symptoms.
Colon cancer treatment
Treatment of colon cancer usually involves surgery. And it may also involve chemotherapy; radiation therapy is only rarely needed.
Surgery: the initial treatment of colon cancer usually involves surgery. During the surgery, the cancerous part of the colon and surrounding tissues are removed. The lymph nodes within this surrounding tissue are examined under a microscope to determine if cancer has spread beyond the colon.
In most people, the two ends of the colon can be reconnected immediately after the cancerous part has been removed. If this can be done, it means bowel movements will continue normally through rectum and anus.
In other cases, the colon cannot be reconnected during the initial surgery. This can happen if there is a high chance that the reconnection will fail or if the tissues are inflamed and need time to heal. If this occurs, the surgeon will sew the colon and at times the small bowel to an opening in the skin on the abdomen. The opening is called an ostomy (colostomy if the colon is sewn to the abdominal wall or ileostomy if the ileum is sewn to the abdominal wall). A bag will cover over the ostomy to collect bowel movements.
The ostomy is usually temporary. The two ends of the colon can be reconnected after a few months otherwise the colostomy will remain permanently.
Chemotherapy: Chemotherapy is a treatment given to slow or stop the growth of cancer cells. Even after a colon cancer has been completely removed with surgery, cancer cells can remain in the body, increasing the risk of the cancer recurrence. In some people, chemotherapy can eliminate these cancer cells and increase the chance of cure. The oncologist determines what medications and for how long should be used in chemotherapy.
Follow-up after treatment
After completing treatment for colon cancer, it is important to follow up with your doctor. You will need appointments on a regular basis for a few years to monitor for signs that the cancer has recurred.
- A full colonoscopy before or after surgery to evaluate the primary cancer and to look for polyps or other cancers. Colonoscopy is usually repeated one year after surgery, and if this is normal, then every three to five years thereafter. If polyps or new cancers are found, this schedule may be adjusted.
- After completing the treatment, you should visit your doctor every three to six months for two to five years and after that every six months for two years.
- CT scan is usually recommended once per year for at least three years in people who have been treated for stage 2 or stage 3 colon cancer.
Colon cancer and your family
Parents, sisters, brothers, and children of patients with colon cancer are at higher risk for colon cancer. Colonoscopy screening for relatives of people with colon cancer should begin at age 40 or 10 years earlier than the youngest person with colon cancer. Certain genetic conditions increase the risk of colon cancer, such as Lynch syndrome (hereditary non-polyp colon cancer) and familial adenomatous polyposis (FAP). If 2 or more close family members have had colon cancer, they should talk to their doctor about genetic counseling.
