Understanding Colon Cancer -- Diagnosis and Treatment
How Is Colorectal Cancer Diagnosed?
Beginning at the age of 50, everyone should be screened regularly for colorectal cancer (earlier screening is recommended for some high-risk groups). There are several options.
The traditional screening routine was for the doctor to perform a digital rectal exam once a year and for you to collect three stool samples to be tested for traces of blood. Also, every three to five years you would receive a sigmoidoscopy and a double-contrast barium enema to look at the lower part of the bowel. If anything were abnormal then you would be referred for a colonoscopy. The colonoscopy is a complete evaluation of the colon and rectum with a scope or long, flexible tube similar to the sigmoidoscope but longer.
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Biopsies or tissue samples of any suspicious-looking areas can be obtained during a colonoscopy for laboratory analysis.
Now, most doctors advocate going right to colonoscopy every 10 years. However, other studies are sometimes recommended when a patient is unable or unwilling to undergo colonoscopy.
A noninvasive screening procedure called virtual colonoscopy is becoming available. It does away with the tube and instead uses spiral computed tomography, which produces a three-dimensional image of the colon after it has been emptied and partially inflated with air.
The current American Cancer screening guidelines for colon cancer in an average risk patient begin at the age of 50 and include: testing of stool samples for traces of blood yearly, a flexible sigmoidoscopy every five years, a double contrast barium enema every five years, virtual colonoscopy every five years, and a colonoscopy every 10 years. However, if you are at high risk of colon cancer due to a family history of colon cancer or polyps, or if you are African-American, screening intervals should begin earlier and be more frequent.
Any suspicious symptoms or abnormalities will alert your doctor to perform a colonoscopy to get a biopsy.
Should a biopsy confirm cancer, imaging tests using chest X-rays and CT scans of the abdomen, pelvis, and possibly chest are performed to find out whether the cancer has spread to other sites. Positron Emission Tomography (PET) scanning is a highly sensitive study for detecting colon cancer metastasis. Usually this test is more helpful in detecting recurrences than when used for the initial staging of early disease.
Blood tests will also be ordered to find out how well the liver and kidneys are functioning, to determine if you are anemic, and to measure the blood level of a substance called carcinoembryonic antigen (CEA), often found in higher-than-normal concentration in the presence of colorectal cancer, especially if it has spread.
What Are the Treatments for Colorectal Cancer?
Colorectal cancer treatment involves not only specific therapies for curing or controlling the disease, but also strategies for meeting a patient's emotional and physical needs. Restoring and maintaining quality of life is a central issue for doctors, as it should be for family members and friends as well. Many complementary cancer therapies can be valuable adjuncts when pursued along with standard medical treatment to help make the stresses of cancer and its treatment more tolerable. However, complementary therapies should never replace standard care.
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