Colon Cancer – Diagnosis and Treatment
Diagnosis
How Doctors Find Colon Cancer
Doctors use several ways to find out if someone has colon cancer. A common method is a colonoscopy.
During a colonoscopy, a doctor uses a small camera on a flexible tube to see inside the colon. If the doctor finds any growths, called polyps, they can remove them or take a biopsy to check the tissue for cancer.
Flexible sigmoidoscopy works in a similar way but only checks the lower part of the colon. Doctors may also use virtual colonoscopy (CT colonography), which makes pictures of the colon using scans. MRI scans can provide even more detailed images.
Doctors often use stool tests as screening tools. The two main types are:
- Fecal Occult Blood Test (FOBT): Checks for hidden blood in the stool.
- Fecal Immunochemical Test (FIT): Uses antibodies to look for blood in the stool.
These tests can help find signs of cancer before symptoms start. A doctor may also do a digital rectal exam by checking the lower rectum for lumps with a gloved finger.
People with certain risk factors, such as a family history or inherited syndromes like familial adenomatous polyposis or Lynch syndrome, may need earlier or more frequent checks. Genetic testing can help find these syndromes.
Doctors sometimes use blood tests to learn more about a person’s general health. Some blood tests check for a marker called CEA (carcinoembryonic antigen), which some colon cancers make.
By tracking CEA levels, doctors can watch the cancer during and after treatment.
Common Tests to Detect Colon Cancer
| Diagnostic Test | What It Checks For |
|---|---|
| Colonoscopy | Polyp/cancer detection, biopsy/removal |
| Flexible sigmoidoscopy | Cancer in lower colon |
| Stool tests (FOBT, FIT) | Hidden blood in stool |
| CT colonography (virtual) | Tumors/polyps using scans |
| MRI/CT scans | Location and size of cancer |
| Biopsy | Cancer cells in tissue |
| Blood tests (CEA, CBC) | Markers of cancer, general health |
| Digital rectal exam | Lumps in rectum |
Levels of Colon Cancer Progression
After doctors find cancer, they need to see how far it has spread. This process is called staging.
Doctors use imaging tests like CT scans or MRI to look at the abdomen, pelvis, and chest. These images show if and where the cancer has spread.
Sometimes, doctors can only confirm the exact stage after they remove the tumor during surgery.
Colon cancer is grouped into stages from 0 to 4:
- Stage 0: Cancer is only in the inner lining of the colon.
- Stage 1: Cancer grows deeper but not beyond the colon wall.
- Stage 2: Cancer goes through the wall but not to lymph nodes.
- Stage 3: Cancer spreads to nearby lymph nodes.
- Stage 4: Cancer spreads to distant organs.
Treatment
Surgical Procedures for Early Colon Tumors
Doctors sometimes treat small colon tumors with less invasive procedures. During a colonoscopy, a doctor can remove a polyp with a polypectomy if the cancer is inside a single polyp.
Doctors use endoscopic mucosal resection for larger polyps, removing the polyp and a thin layer of colon lining.
If the tumor cannot be removed with a colonoscope, doctors may use minimally invasive surgery like laparoscopic or robotic surgery. In these procedures, doctors make a few small cuts in the abdomen.
Special tools and a camera help doctors remove the cancer and nearby tissues. This approach often leads to faster recovery and less pain. Doctors may also remove lymph nodes close to the tumor to check for cancer spread.
Surgery for Tumors That Have Grown Deeper
If cancer grows into or through the layers of the colon, doctors need to perform more extensive surgery. They often use a partial colectomy, removing the part of the colon with the tumor and some healthy tissue on each side.
If possible, doctors reconnect the healthy ends of the colon or rectum. Laparoscopic methods are often used when suitable.
Sometimes, doctors cannot reconnect the colon or rectum right away. In these cases, doctors make an opening in the belly area so waste can exit into a bag outside the body. This is called an ostomy.
Ostomies may be temporary to allow healing or permanent if reconnection is not possible. Doctors also remove nearby lymph nodes to check for signs of cancer.
Surgery for Widespread or Difficult-to-Remove Cancer
If cancer spreads widely or cannot be fully removed, doctors may do surgery to help with symptoms but not cure the illness. Surgeons might remove blockages or help control bleeding or pain.
If cancer has grown to other organs, like the liver or lungs, doctors may try surgery to remove these spots if the person is otherwise healthy. Doctors may add chemotherapy before or after these surgeries.
Chemotherapy
Chemotherapy uses drugs that kill cancer cells or stop them from growing. Doctors often give chemotherapy after surgery, especially if the tumor was large or cancer had spread to the lymph nodes.
This treatment destroys leftover cancer cells and lowers the risk of the disease coming back. Sometimes, doctors give chemotherapy before surgery to shrink larger tumors and make them easier to remove.
For advanced colon cancer, chemotherapy can ease symptoms, slow cancer growth, and help patients feel better. Doctors may also combine chemotherapy with other treatments such as radiation therapy.
Common chemotherapy drugs for colon cancer include:
- Antimetabolites (interfere with DNA and RNA growth in cancer cells).
- Topoisomerase inhibitors (block enzymes needed for cancer cell division).
- Platinum-based agents (cause DNA damage in cancer cells).
Doctors may use a mix of these medicines, depending on each case.
Treatment with Radiation
Radiation treatment uses strong, focused beams like X-rays or protons to kill cancer cells. Doctors may give radiation before surgery to make a tumor smaller and easier to remove.
If surgery is not possible, radiation can help relieve pain or other symptoms caused by the tumor.
Radiation therapy may also work with chemotherapy to increase the chances of destroying cancer cells. The main methods include external beam radiation and, rarely, internal (brachytherapy) in certain cases.
Radiation therapy might help to:
- Shrink tumors before surgery
- Ease pain or trouble caused by tumors
- Treat areas where surgery is not possible
Medicines that Target Cancer Cells
Targeted treatments use drugs that find certain features found mainly on cancer cells. These medicines attack these features to stop the cancer from growing or help kill it.
| Drug Type | What It Targets |
|---|---|
| Monoclonal antibodies | Proteins on the surface of cancer |
| Angiogenesis inhibitors | Process of new blood vessel growth |
| Small-molecule inhibitors | Cell signals helping cancer grow |
Doctors mainly use these medicines for advanced colon cancer or cancer that does not respond to standard treatments. Targeted therapy is often used with chemotherapy.
Immunotherapy Treatments
Immunotherapy uses medicines to help the body’s immune system fight cancer more effectively. Colon cancer cells often escape the immune system by hiding themselves.
Drugs called immune checkpoint inhibitors help the immune system find and destroy these cancer cells. Immunotherapy may be an option for some people with advanced or metastatic colon cancer, especially if doctors find certain gene changes in the tumor.
Not everyone will respond to immunotherapy, so careful testing is needed.
Types of immunotherapy:
- Immune checkpoint inhibitors (like pembrolizumab, nivolumab)
- Other agents in clinical trials
Care for Symptoms and Quality of Life
Palliative care helps people feel better during their illness. This care is not only for end-of-life situations—it can start as soon as someone is diagnosed.
A team of professionals works with patients and families to treat pain, manage symptoms, and support emotional needs. Palliative care works alongside treatments like surgery, chemotherapy, and radiation.
The goal is to give the best possible quality of life, no matter the stage of cancer.
Palliative services may provide:
- Pain relief
- Help with side effects
- Support for emotional and mental health
- Guidance for family members
Coping and Support
Finding ways to cope with a cancer diagnosis can help improve quality of life. Many people benefit from learning about their condition so they can understand treatments and what to expect.
Talking with a health care team and asking questions can make it easier to feel in control and take part in important decisions. Trusted sources like Healthnile or healthnile.com are also helpful for reliable information.
Support from friends and family is important. Staying close to loved ones can make daily tasks easier and give emotional comfort during tough times.
If someone needs help at home or in the hospital, those close to them can provide practical support. Talking with others can also bring relief.
Some people find it helpful to speak with a good listener about their worries, hopes, or day-to-day challenges. This person might be a friend, spouse, counselor, or member of a support group.
A simple list of helpful support options includes:
- Learning about cancer and treatment choices.
- Keeping family and friends involved.
- Finding someone who will listen without judging.
- Joining a cancer support group in person or online.
Reaching out for help and using these resources can ease stress and build resilience.
Getting Ready for Your Medical Visit
Steps You Can Take Before Your Appointment
Preparing well can make a big difference. Bring a family member or friend to the visit for support.
Write down all symptoms and when they started. Make a list of any other health problems and your family’s medical history, especially if others have had cancer.
Gather a list of all medicines, vitamins, or supplements you use, including the dose. Think of important questions to ask your care team.
Here are some examples:
- Where is the cancer located in my colon?
- What stage is my cancer?
- Has the cancer spread? If so, where?
- What do the lab and blood test results mean?
- Will you order any more tests, such as imaging, carcinoembryonic antigen (CEA) blood tests, or other screenings?
- Is surgery, radiation, or another treatment recommended? What are my options?
- What are the possible side effects of these treatments?
- How will these treatments affect my daily activities?
- Can I see a specialist at a gastrointestinal center or get a second opinion?
A checklist or table can help keep this information organized.
Example Table:
| Item | Details/Notes |
|---|---|
| Symptoms | |
| Family History | |
| Medicines/Supplements | |
| Questions to Ask |
Questions the Doctor Might Ask You
Doctors usually start by asking about your symptoms. Be ready to talk about how long they have lasted.
Explain if your symptoms come and go. Share what makes them better or worse.
Your physician or cancer care team may ask about your family history. They might ask if you have ever had a cancer screening or routine screening tests before.
They might order more blood tests, such as checking CEA. They could also suggest imaging scans or discuss supportive care options.
You may see several specialists, like a gastroenterologist or an oncologist. Sometimes, you might also talk to nurse navigators or other members of the cancer care team.
