New Jersey Hematology Oncology Associates

from Ocean County Woman - July/August 2021

Nina Radcliff, MD

16 Medical Professionals Colon Cancer

Dr. Apurv Agrawal

Colon cancer is the third most common cancer globally. In the United States colon cancer accounts for 8% of total cancer deaths. It is seen more often in men than women. The incidence of colon cancer in the United States has been decreasing. Risk factors for developing colon cancer include: genetics, inflammatory bowel disease, consumption of processed and red meat, obesity, as well as cigarette smoking, and alcohol use.

One of the likely causes of the decreasing incidence of colon cancer in the United States is screening. Screening improves prognosis by making an earlier diagnosis which renders the cancer easier to treat. Also, treatment prior to developing symptoms offers an improved survival rate. Screening helps by detecting pre-cancerous polyps which can be removed before they progress to cancer. Screening methods include a colonoscopy or a stool test among others.

Treatment of colon cancer depends on the stage at diagnosis. The diagnosis is most often made by a colonoscopy. Following a colon cancer diagnosis CT scans or a PET/CT scan is typically ordered to see if the cancer has spread out of the colon. Stages I-III have no spread outside the colon and surgery is the first step in management. At the time of surgery the colon tumor is removed along with a minimum of twelve lymph nodes around the colon. Stage I means that the cancer has spread through the first or second layer of the colon with no involvement of the lymph nodes. Stage I patients do not receive additional treatment after surgery. Stage II colon cancers typically extend deeper through the colon layers with no involvement of local lymph nodes. Stage II patients are usually monitored without additional treatment, though in some cases certain clinical features may lead the oncologist to recommend treatment with chemotherapy. Stage III patients have involvement of the local lymph nodes. Stage III patients are offered 3-6 months of chemotherapy to decrease the risk of recurrence of the cancer and improve survival rates. Stage IV colon cancer patients have spread of the cancer outside of the colon. Most often their cancer has spread to the liver and/or lungs. Treatment in stage IV patients involves chemotherapy and/or targeting treatments based on certain molecular features seen in the cancer itself. In some cases the tumor can be removed not only from the colon but also from the involved part of the liver or lung.

There are a number of good treatments options for colon cancer. Nothing however is better than regular colon cancer screening which typically leads to an earlier diagnosis and better survival rates.