Colon cancer

Alternative Names

Treatment

Treatment depends partly on the stage of the cancer. In general, treatments may include:

• Chemotherapy medicines to kill cancer cells
• Surgery to remove cancer cells
• Radiation therapy to destroy cancerous tissue

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.

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

Chemotherapy is also used to treat patients with stage IV colon cancer. Irinotecan, oxaliplatin, and 5-fluorouracil are the three most commonly used drugs. You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluroruracil.

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 cutting out the cancer, burning it (ablation), or freezing it (cryotherapy). Chemotherapy or radiation can sometimes be delivered directly into the liver.

While 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.

Support Groups

For additional resources and information, see colon cancer support groups.

Outlook (Prognosis)

How well a patient does depends on many things, including the stage of the cancer. In general, when treated at an early stage, more than 90% of patients survive at least 5 years after their diagnosis. (This is called the 5-year survival rate.) However, only about 39% of colorectal cancer is found at an early stage. The 5-year survival rate drops considerably once the cancer has spread.

If the patient's 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 curable.

Possible Complications

• Cancer spreading to other organs or tissues (metastasis)
• Recurrence of carcinoma within the colon
• Development of a second primary colorectal cancer

When to Contact a Medical Professional

Colon cancer is, in almost all cases, a treatable disease if caught early. Removal of pre-cancerous polyps by colonoscopy essentially prevents colon cancer. If you are age 50 or older and have not yet had a colonoscopy, you should ask your health care provider about scheduling one. Early colon cancer usually has no symptoms, so screening by colonoscopy is important.

You should also call your health care provider if you have blood during a bowel movement, black, tar-like stools, or a change in bowel habits.

References

U.S. Preventive Services Task Force. Routine Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2007 Mar 6;146 (5): 361-364.

American Cancer Society. Cancer Facts and Figures 2006. Atlanta, GA: American Cancer Society; 2006.