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Cancerous cells in the colon are called colon cancer. The colon, or large bowel, measures about 5 feet in length. It is part of the body’s digestive system, which is responsible for processing nutrients and getting rid of waste.
Colon cancer often starts in adenomatous polyps of the colon. These polyps are a precancerous condition that can develop into cancer and invade the intestinal wall. The most common type of colon cancer is adenocarcinoma. Other types include:
- Carcinoid tumors.
- Lymphomas.
- Gastrointestinal stromal tumors (GISTs).
- Sarcomas.
What is Staging and How is it Performed?
Staging is a way to find out if and where cancer has spread in your body. Your doctor will have you get a few tests to figure out the stage of your cancer. These tests may include:
Physical Exam: This is a general exam to look at your body and to talk about your past health issues.
Laboratory Tests: Blood is drawn to check the function of the kidneys and liver, as well as a complete blood count (CBC). A carcinoembryonic antigen (CEA) level may also be checked.
Imaging: Radiology tests can look inside your body at the cancer and see if it has spread. These tests can include:
- Chest X-ray.
- CAT scan (CT scan).
- Magnetic resonance imaging (MRI).
- Virtual colonoscopy.
- Positron emission tomography scan (PET scan).
Procedures: Each case of colon cancer is different. Talk with your doctor about which procedures may be part of your treatment plan. These options may include:
- Sigmoidoscopy: A sigmoidoscope (lighted, flexible tube) is inserted into the rectum and the lower portion of the colon (sigmoid colon) to look for any abnormalities. Biopsies can be done during a sigmoidoscopy.
- Double-contrast barium enema: Also known as a lower GI series, this test uses the liquid enema contrast barium and X-rays to see changes in the lower gastrointestinal tract, including the colon and the rectum.
- Colonoscopy: A colonoscope (lighted, flexible tube) is inserted into the rectum, looking at the whole colon for any abnormalities. Biopsies may be done during a colonoscopy.
- Biopsy: The removal of a piece of tissue to be looked at with a microscope to look for cancer cells.
Colon cancer spreads to other parts of the body through the tissue, lymph, and blood systems. Cancer stage determines how extensive the cancer is, how far it has spread and what treatment course will be recommended. Colon cancer is described as stages 0 through stage IV disease, with higher stage being more advanced.
Surgical Procedures for Colon Cancer
There are many types of surgery used to treat colon cancer. The type of surgery you have will depend on your health and if the cancer has spread. Some surgeries include:
Polypectomy/Local Excision: A colonoscope (as in the colonoscopy) is used to remove a polyp or abnormal area of cancer. During a polypectomy, only the polyp is removed, whereas during a local excision (also known as an endoscopic mucosal resection), some of the tissue on the colon wall is also removed.
Colon resection: The larger cancer is removed by doing a colectomy. There are two types of colectomy:
Partial colectomy: Also called a hemicolectomy or segmental resection, this procedure removes the cancer and some surrounding healthy tissue. This procedure will require either an anastomosis or colostomy. When the surgeon sews the two ends of the colon back together, this is referred to as an anastomosis. In some cases a permanent or temporary colostomy or ileostomy is required. This will allow for waste (stool) to be passed through an external opening (stoma) into a colostomy collection bag. Lymph nodes may also be removed during this procedure.
Total Colectomy: The entire colon is removed. Lymph nodes may also be removed during this procedure. This may require a permanent colostomy to remove waste (stool) from the body.
Laparoscopy: Several small incisions are made to allow for the passage of special surgical tools which will remove the abnormal areas.
Palliative surgery: The goal of surgery is not to remove the cancer, but to relieve symptoms like pain caused by the effects of cancer, such as blockages.
Surgery for metastatic disease: At times, colon cancer may spread to other parts of the body, such as the lungs or liver, and it may be recommended that these areas be removed.
