Colon Cancer : In Depth - Understanding...
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Because some symptoms of colorectal cancer can also be caused by other, less serious problems, a person should discuss them with his or her doctor. To determine the cause of any symptoms, a doctor will perform a careful physical exam and ask the person about his or her personal and family medical history. The doctor may also do one or more diagnostic tests.
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Sometimes cancers or polyps bleed. An FOBT checks for blood in your stool. It's a highly sensitive test, which means it can find polyps and cancer. However, sometimes the test can indicate that there's a polyp or cancer when there isn't. This is called a false positive. Or it can miss a polyp that doesn't bleed. Therefore it's commonly used as an initial test before another screening test such as a colonoscopy or a sigmoidoscopy.
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Colonoscopy is used to view the inside of your lower digestive tract (colon and rectum). It can help screen for colon cancer and can also help find the source of abdominal pain, bleeding, and changes in bowel habits. The test is usually done in the hospital on an outpatient basis. During the exam, the doctor can remove a small tissue sample ( a biopsy) for testing. Small growths, such as polyps, may also be removed during colonoscopy.
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A colonoscopy is an examination of your entire colon. For it, your doctor uses a small video camera that's attached to a thin tube called a colonoscope. The camera sends images to a small TV screen, and your doctor can see if anything looks unusual. If your doctor finds a small polyp during the test, he or she can remove it and send it to a lab for testing to see if it is cancerous. The removal of tissue is called a biopsy. Your doctor will take a biopsy of a tumor, large polyp, or anything else abnormal that's found.
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Virtual colonoscopy is an investigational newer screening method that uses radiation to take pictures of your colon. The pictures are taken using a computed tomography, also called CT, scanner. Unlike the flat pictures from an X-ray, the CT scanner makes a three-dimensional computer image of your whole colon. The test is 90% accurate in finding colon polyps as small as 1 cm. But it is only 25% accurate at finding polyps smaller than 5 mm. So it is not as accurate as a colonoscopy.
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This year more than 145,000 new cases of colorectal cancer will be diagnosed in the United States. In a large number of those cases, the cancer will be advanced. That means they'll be harder to treat. That also means they'll be more likely to be fatal. The earlier colorectal cancer is found, the easier it is to treat. And that makes a cure more likely. You can even prevent the disease if polyps in the colon and rectum are found and removed before they become cancerous.
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Lower GI endoscopy allows your doctor to view your lower gastrointestinal (GI) tract. Your entire colon and rectum can be examined (colonoscopy). Or just the rectum and sigmoid colon can be examined (sigmoidoscopy).
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A DCBE is also called a lower gastrointestinal series. It is a way to use X-rays to locate polyps and colon cancer. It is a very effective tool for finding large colon polyps and cancer. But it only finds polyps smaller than 1 cm about half the time. So it is a better exam for diagnosing colorectal cancer than for catching it early. Consequently, it is used mainly when you can't have a colonoscopy, but it is not considered standard of care at this time.
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If you're 50 or over, the American Cancer Society recommends having this test every 3 to 5 years.
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Your lower colon is also known as your sigmoid colon. A sigmoidoscopy is an examination of your rectum and lower colon using a lighted instrument called a sigmoidoscope.
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If a biopsy shows cancer is present, further tests will most likely be recommended to check if the tumor has spread. These tests include a CT scan of the abdomen and liver MRI scans, or ultrasound, to check if the tumor has spread. Certain blood tests may also be conducted.
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There are very few things scarier than being told you have cancer. You may feel like you're in shock. You may not even want to believe what the doctor has told you. And there are probably so many questions you want to ask but think you can't because you don't know where to start.
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A kind of cancer called adenocarcinoma accounts for more than 95% of colorectal cancers. It is the type we focus on in this section. These are other types of cancer that can be found in the colon and rectum. But they are rare.
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Your doctor did a biopsy to determine that you had cancer. The doctor did this by taking a sample of cells or fluid from an area that looked suspicious in your colon. Your doctor may now ask for more tests. These tests will help the doctor learn about your specific cancer. Your doctor needs to know what stage your cancer is and whether it has spread. With this information, you and your doctor can decide on a treatment plan. The doctor may also ask for tests to assess your overall health. These tests will show if the cancer has caused other health problems. They will also show whether other health problems might interfere with your treatment for cancer.
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Abdominal ultrasound is an imaging test that uses sound waves to form pictures of your abdominal organs. It can help detect organ problems, such as gallstones, kidney stones, or liver disease.
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Computed tomography (CT) is a test that combines x-rays and computer scans. The result is a detailed picture that can show problems with soft tissues (such as the lining of your sinuses), organs (such as your kidneys or lungs), and bones.
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Magnetic resonance imaging (MRI) is a test that lets your doctor see detailed pictures of the inside of your body. MRI combines the use of strong magnets and radio waves to form an MRI image.
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An x-ray uses a small amount of radiation to create images of your bones and internal organs. X-rays are most often used to detect bone or joint problems, or to check the heart and lungs (chest x-ray).
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Finding cancer at its earliest stage can give the best chance of being able to cure it. Different tests are used to find cancers and to help find out if the cancer has spread. A positron-emission tomography (PET) scan is one type of test that can help find and stage cancers as well as monitor how well treatment is working.
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The original cancer is called the primary tumor. Your colon has several layers of tissue, and as the primary tumor grows, it extends through these layers. Once it has grown through all the layers, the cancer can spread to nearby tissue or organs. At this point, the cancer can spread to nearby lymph nodes. Then in its later stages, it may spread to distant parts of your body, such as your liver or lungs.
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As colorectal cancer grows, it spreads through the wall of your colon or rectum. Then, like all cancers, it can spread to other parts of the body. Both the process and the cancer are called metastasis or metastatic cancer. The stage of your cancer is a way doctors describe how deep and how far your cancer has spread. Knowing the stage is important. The stage is a primary factor in deciding what treatment to use.
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A prognosis is a statement about the prospect of surviving and recovering from a disease. It may seem hard to ask, "Can I survive this?” But it's a question most people have when they learn they have cancer. Unfortunately, there isn't an easy answer.
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If colorectal cancer is caught early, the 5-year survival rate is very good. For cancer caught at a later stage, the 5-year rate is less favorable.
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