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Colorectal Cancer Treatment

Diagnosis and Staging

The diagnosis of colon cancer is typically made with a sigmoidoscopy or colonoscopy with a biopsy. The usual histology is adenocarcinoma, although lymphoma, melanoma, and sarcomas can be found in the colon, rectum, or anus. Staging procedures establish the extent of the cancer, and typically involve labs, a chest x-ray, and CT scans of the abdomen and pelvis. Patients with rectal cancer may also need a rectal ultrasound to improve the staging of the tumor and to help with treatment planning.

Treatment

Surgery is the primary treatment modality in the care of patients with colorectal cancer. A surgeon who is knowledgeable about cancer operations should perform the operation, and careful attention to other abdominal organs is essential to determine if the cancer has spread (metastasized). If the cancer involves the lymph nodes but has not spread to other areas of the body (Stage III), then chemotherapy with 5-fluorouracil and leucovorin should be given for 6 months to reduce the risk of recurrence and improve the chances of survival. If the cancer has spread to other areas of the body (Stage IV), the patient should be evaluated for resection of limited lesions in the lung or liver. If that is not feasible, chemotherapy has been suggested to improve survival and quality of life, but is not curative.

Rectal cancer presents a special circumstance and is typically treated with a modified approach. If the cancer is close to the anus, surgery may require placement of a permanent colostomy. Several centers, including Ellis Fischel, have developed approaches using chemotherapy and radiation therapy before surgery. This approach leads to a reduction in the number of patients who will require a permanent colostomy, and allows many patients to lead a normal life after treatment is completed.

More information about the treatment of colorectal cancer is available at Cancer Net at the National Cancer Institute.

Clinical Trials

In spite of the improvements in the detection and treatment of colorectal cancer, the fact remains that many Americans still die of the disease each year. Clinical trials look at new therapies, and compare new approaches with those of old to advance care and improve outcomes. Many clinical trials are available here and nationwide for treatment of colon cancer, and patients should be offered and encouraged to consider these opportunities. To learn more about clinical trials, visit Cancer Trials at the National Cancer Institute.