OVERVIEW
This page is dedicated to providing readers a clear frameowrk for thinking about the broad topic of colon cancer. There are many consideratios that need to be made when the diagnosis of “colon cancer” is given, and a clear approach to this subsection of cancer is very useful clincially.
WHAT EXACTLY IS IT?
Becasue there are a few disease processes that fall under the broader term “colon cancer” it is very important to define what exaclty the term “colon cancer” refers to. Technically any malignancy that originates priamry from the colon (large intenstive) can be given the moniker “colon cancer”.
With ths in mind, here are some specific types of colon cancer.
UNIVERSAL ASPECTS OF CANCER THAT ARE RELVANT
When thinking about any type of malingnancy, there are a few unviersal concpets that are worth considering. These concepts also apply in the realm of colon cancer as well and include:
- Screening: all cancers have some method of screening that is employed in the clincial setting. Some screening practices are more effective than others.
- Diagnosis: for any cancer we must first make sure that it actually IS cancer.
- Staging: cancer is not a static disease process. For any type of cancer it is important to characterize how advanced the disease actually is (i.e. the stage of the malignancy)
- Treatment: while curing cancer may not always be possible, some form of treatment (even if it is palliative) generally will exist.
Diagnosising Colon Cancer:
While there can be many different presentations of different types of colon cancer, it is important to appreciate that the ULTIMATE diagnosis of colon cancer requires histologial anlysis. The tissue can be obtained either in the form of a biopsy (during a procedure such as a colonoscopy) or from a surgical specimen (from a surgery such as a colectomy).
Staging Colon Cancer:
Lymphnodes: in the case of colon cancer it is generally thought that obtaining at least 12 lymph nodes is needed to properly stage the tumor.
Treating Colon Cancer:
Surgery: colon cancer is a bit unique in regards to surgical treatment. Typically in other cancer contexts (i.e. for lung cancer) if the primary tumor has metastasized (and the patient has advanced disease) the pateint often times will become “non-surgical”. This is becasue the value of removing the primary malignancy in the setting of widespread disease is thought to be minimal. In the case of colon cancer, the risk of a growing primary tumor obstructing the GI tract justifies surgical intervention even in the settign of advanced/metastasized disease. If fro some reason the patinet is unable to tolerate resection of the tumor (for exampel their nutritional status is poor etc) then a stent may be placed in the colon to ensure that it is kept patent.
Radiation: typically cancers that are in the colon do not receive radiation therpay, and those in the rectum do.
Chemotherapy: