Colon cancer treatments making strides
Colon cancer is the third most common cancer among women and men in the U.S., but globally it varies widely among different geographic areas.
The disease can have a high cure rate if detected early, with the main detection tool a colonoscopy, which is recommended for anyone over the age of 50.
If the patient has a strong family history of colon cancer, he or she may want to have a colonoscopy done much earlier than 50 years old. In some individuals with a genetic predisposition to colon cancer, they may undergo a total colectomy before there is any evidence of colon cancer.
Treatment improves
Approximately 80 percent of colon cancers are in the colon and regional lymph nodes, therefore, surgery is the only cure for localized colon cancer.
The goal of surgery is to completely remove the tumor and the lymphatic drainage basin of the affected colon segment, with most colon cancers removed by a laparoscopic approach. In addition, robotic colon resections are becoming more common.
With both approaches, there is less pain and a faster recovery.
During a colon resection, it is important to completely remove the involved colon along with a suitable number of lymph nodes to adequately stage the patient. Staging allows for prediction of long-term survival and determines whether any further adjuvant treatment is necessary.
In patients who have positive lymph nodes, adjuvant chemotherapy is recommended. Chemotherapy, which generally happens six months at a time, reduces the risk of the disease reoccurring by approximately 30 percent, with most treatment options involving a combination of several chemotherapy agents.
Patients without positive lymph nodes, the benefits of chemotherapy are less dramatic. In these patients, the use of chemotherapy should be individualized.
What if it spreads?
Approximately 20 percent of patients with colon cancer will have metastatic disease at the time of their initial diagnosis, and 60 percent will develop liver metastasis at some point in the life.
Because of those statistics, there have been many different model developed for the treatment of liver metastasis due to colon cancer.
That includes surgery, ablation techniques, and radioembolization of the liver. The use of the techniques depends on the location and the extent of the disease in the liver. Patients should be referred to a center that has all techniques available.
It is also important that patients with advanced colon cancer be evaluated by a multidisciplinary team that has the ability to provide the different therapies that may be suitable to them such as Advocate Sherman Hospital.
The good news
The good news with colon cancer is that we now have many different chemotherapy agents and many other suitable procedures available to treat patients with even an advanced case.
It is also a disease that if diagnosed early enough, it has a high cure rate.
The recommendation is that we should undergo a colonoscopy at 50, and if there are any polyps seen, they can usually be removed endoscopically.
However, if a patient does have advanced colon cancer, we now have the ability to treat it in a fashion where we can expect long-term survival.
Colon cancer is no longer a death sentence – it can be treated even in advanced states with the hope of long-term survival.
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About the Author
Dr. John Brems‘ is the director of the Center for Advanced Liver and Pancreatic Care at Elgin-based Advocate Sherman Hospital and specializes in the surgical treatment of liver and pancreatic diseases. Over the years, he has performed thousands of liver transplants, major liver resections and liver-heart transplants. He helped create the center, which opened in 2011 and offers progressive procedures and techniques to treat a wide range of liver and pancreatic cancers and diseases.
I think many of us put a colonoscopy appointment on the back burner because we don’t understand the importance of them. Colon cancer is very dangerous, so it is crucial to catch it early!
jasmine and jarrett
Wondering if I need to get one soon. This article reminded me to schedule my annual check up. Thank you!
I always dread getting a colonoscopy. The prep is a real challenge for me. But, I do it! http://colorectal-surgeon.com.au/colonoscopy/
hello Dr. Brems, would you happen to know if the WILMOT CENTER, part of Strong Memorial Hospital in Rochester, ny? I believe they are “up” on treatments for cases of advanced cancer…do you know if this is correct? also, wonder if you know whether they employ immunotherapy when appropriate?
Thanks for any help you can provide. connie fiocco.