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Colon Cancer Screening and Diagnostic Tests

Cancer that starts in the colon (the longest part of your large intestine). It can also be spread to other parts of the body. Screening can help find and eliminate precancerous polyps prior to they become cancerous.

Doctors use a method known as staging to determine the degree of cancer's development. This information aids doctors in deciding the best treatment for you.

Surgery

Most people with stage colon cancer may be treated by surgery to remove the polyp or part of the colon that is cancerous and lymph nodes nearby. This procedure is typically followed by chemotherapy (called adjuvant therapy) to kill any remaining cancer cells.

Your doctor will conduct an examination for your physical health and ask about any previous health issues. There are other tests you can have like blood work, a chest x-ray, an electrocardiogram (ECG) and a CT scan of the abdomen or pelvis and a stool sample that's tested for genetic changes that could indicate of colon cancer.

If the tumor is in a polyp or in an region of the colon not a part of the rectum, the surgeon may be able to remove it with the colonoscopy. If the cancer has spread to adjacent tissue or is located in an area that is larger than the colon, you'll require further surgery.

You may need the procedure known as a colectomy or diverting colostomy. Surgery is often able to reconnect healthy tissue however, if they cannot make an opening, you'll need a hole in the wall of your abdomen (ostomy) to allow waste to be removed from your body. This is typically an interim solution until the colon heals.

Sometimes, a surgeon may use a less invasive procedure like cryosurgery or radiofrequency ablation. These procedures use the probe to heat or freeze tissue that is abnormal.

Chemotherapy

Colon cancer (and rectal cancer, which begins in the rectum) is usually cured with surgery or other treatments if it is detected early. Regular screening tests are the best method of detecting colon cancer as well as polyps that could develop into cancer. Physical exams and blood tests are included. Other tests include a virtual colonoscopy which is a series of pictures taken by an elastic tube (colonoscopy) to see the entire length of your colon and stool DNA tests which test for changes in your DNA that could be an indication of colon cancer.

If you have stage I or II colon cancer or in the event that it has developed to the lymph nodes, chemotherapy may aid in stopping the cancer from recurring after surgery. Your doctor will suggest the appropriate combination of drugs for you, depending on the nature of the cancer and its location in your colon. These drugs might include leucovorin or 5-FU, the oxaliplatin or capecitabine.

You might also consider taking part in a clinical trial of newer cancer treatments. These trials assess whether promising new treatments are safe and efficient. On the NCI's website, you can find out more about clinical trial. Ask your doctor whether a clinical study is the right choice for you.

Therapy with radiation

Stage IV is when cancer has spread beyond the rectum, colon and other organs like the liver or lungs. Your doctor might be in a position to treat it through surgery or radiation and chemotherapy. Clinical trials are also testing new types of treatment.

Surgery can eliminate part or all of the colon as well as an adjacent lymph node to prevent cancer from returning (recurrence). Your surgeon will do everything to ensure that the bowel function is maintained and can perform a minimally-invasive operation by making small incisions along your abdomen.

Chemotherapy employs drugs to kill cancerous cells and reduce the chance of colon cancer recurring after surgery. Based on your age and the needs your doctor will prescribe FOLFOX (5 FU, leucovorin, and Oxaliplatin), CapeOx (capecitabine and oxaliplatin), or another chemotherapy regimen.

Radiation therapy destroys cancer cells using powerful energy that includes X proton beams or rays. The use of radiation therapy is to shrink large tumors prior to surgery, or to ease symptoms if surgery isn't an option. Newer versions, like stereotactic and intensity modulated radiotherapy radiation therapy, are able to deliver higher radiation doses more precisely, while keeping healthy tissue from being affected.

Certain cancers produce proteins that block your immune system cells and block them from killing cancerous cells. Drugs that block these proteins can help your immune system fight cancer. Your doctor could prescribe a medicine called PD-1 inhibitor therapy which includes pembrolizumab, or cancer the drug nivolumab.

Other treatments

Doctors are able to detect colon cancer early using a variety of tests for diagnosis and screening. They may look for evidence of the disease in your stool or ask about your family history of colorectal cancer as well as health problems like inflammatory intestinal disease. They may also test your blood to measure levels of the carcinoembryonic antigen (CEA), which is released by cancer cells as well as some normal cells. If the results of these tests are unsatisfactory Healthcare professionals may order additional testing to diagnose colon cancer.

Doctors will assess the extent to which the cancer has spread when deciding on treatment. They may suggest chemotherapy, surgery or a combination.

Duke surgeons are highly skilled at removing colorectal tumors and their surrounding tissue, while maintaining colon function. They employ laparoscopic methods, which makes incisions smaller and allow for faster healing. They can also remove tumors that affect the sphincter, without needing to insert a colostomy bag.

Certain patients with stage IV colon cancer have a good chance of being cured. They may undergo surgery to remove a small section of the liver or lung in which the cancer has spread, or they could undergo cryoablation or radiofrequency ablation in order to remove tumors.

Some patients with colon cancer benefit from targeted treatment, which uses drugs to stop the growth of tumors as well as the spread of cancer to nearby organs or tissues. Doctors may also suggest immunotherapy to combat cancer. This involves using the body's own defenses.