Laparoscopic surgery

Colon Cancer (cont'd)

  • 9-29-2011
  • Categorized in: Cancer

SURGERY

Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy. For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous. (See: Colon resection)

There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.

CHEMOTHERAPY

Almost all patients with stage III colon cancer should receive chemotherapy after surgery for approximately 6 - 8 months. The chemotherapy drug 5-fluorouracil has been shown to increase the chance of a cure in certain patients.

Chemotherapy is also used to improve symptoms and prolong survival in patients with stage IV colon cancer.

  • Irinotecan, oxaliplatin, capecitabine, and 5-fluorouracil are the three most commonly used drugs.
  • Monoclonal antibodies, including cetuximab (Erbitux), panitumumab (Vectibix), bevacizumab (Avastin), and other drugs have been used alone or in combination with chemotherapy.

You may receive just one type, or a combination of these drugs.

RADIATION

Although radiation therapy is occasionally used in patients with colon cancer, it is usually used in combination with chemotherapy for patients with stage III rectal cancer.

For patients with stage IV disease that has spread to the liver, various treatments directed specifically at the liver can be used. This may include:

  • Burning the cancer (ablation)
  • Delivering chemotherapy or radiation directly into the liver
  • Freezing the cancer (cryotherapy)
  • Surgery

Support Groups

For additional resources and information, see: Colon cancer support groups.

Expectations (prognosis)

Colon cancer is, in many cases, a treatable disease if it is caught early.

How well you do depends on many things, including the stage of the cancer. In general, when they are treated at an early stage, many patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.)

If the colon cancer does not come back (recur) within 5 years, it is considered cured. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not considered curable, although there are exceptions.

Complications

  • Blockage of the colon
  • Cancer returning in the colon
  • Cancer spreading to other organs or tissues (metastasis)
  • Development of a second primary colorectal cancer

Calling your health care provider

Call your health care provider if you have:

  • Black, tar-like stools
  • Blood during a bowel movement
  • Change in bowel habits

Prevention

The death rate for colon cancer has dropped in the last 15 years. This may be due to increased awareness and screening by colonoscopy.

Colon cancer can almost always be caught by colonoscopy in its earliest and most curable stages. Almost all men and women age 50 and older should have a colon cancer screening. Patients at risk may need earlier screening.

Colon cancer screening can often find polyps before they become cancerous. Removing these polyps may prevent colon cancer.

For information, see:

Changing your diet and lifestyle is important. Some evidence suggests that low-fat and high-fiber diets may reduce your risk of colon cancer.

Some studies have reported that NSAIDs (aspirinibuprofennaproxencelecoxib) may help reduce the risk of colorectal cancer. However, these medicines can increase your risk for bleeding and heart problems. Most expert organizations do not recommend that most people take these medicines to prevent colon cancer. Talk to your health care provider about this issue.

References

1.       Burt RW, Barthel JS, Dunn KB, et al. NCCN clinical practice guidelines in oncology. Colorectal cancer screening. J Natl Compr Canc Netw. 2010;8:8-61.

2.       Cunningham D, Atkin W, Lenz HJ, Lynch HT, Minsky B, Nordlinger B, et al. Colorectal cancer. Lancet. 2010;375:1030-1047.

3.       Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States, 2010: a review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2010;60:99-119. [PubMed]

Review Date: 12/28/2010.

Reviewed by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

 

A.D.A.M., Disclaimer

A.D.A.M., Disclaimer


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