Colon and Rectal Cancers - Prevention

(Page 2)

Highlights	Treatment	Radiation Treatment
Introduction	Surgery	Follow-up Testing
Causes	Chemotherapy	Treatment for Metastasized Colorectal Cancer
Risk Factors and Prevention	Radiation	Resources
Symptoms	Resources	References
Diagnosis and Screening	References

Stage III.

In stage III, lymph nodes are involved but not distant sites. Stage IIIA and IIIB cancer has spread to as many as three lymph nodes. Stage IIIC cancer involves four or more lymph nodes.
Treatment for stage III colon cancer involves surgery and adjuvant chemotherapy with the FOLFOX regimen (5-FU, leucovorin, oxaliplatin). For patients with stage III rectal cancer, treatment includes chemotherapy and radiation, either before or following surgery.

Stage IV.

Stage IV is metastasized cancer. The cancer has spread to nearby lymph nodes and to other organs of the body such as the liver or lungs.
Treatment for stage IV cancer may sometimes include surgery. When cancer has spread, surgery to remove or bypass obstructions in the intestine may be performed. In these circumstances, surgery is considered palliative in that it may improve symptoms but will not lead to cure. In some cases, surgery may also be performed to remove tumors in areas that the cancer has spread, such as the liver, ovaries, or lung.
Chemotherapy is standard treatment for metastasized cancer. In advanced colorectal cancer, chemotherapy is either given directly into the arteries of the liver when it is involved or intravenously (through a vein) with 5-FU and leucovorin. The targeted therapy biologic drug bevacizumab may also be added. Other alternative chemotherapy choices are capecitabine, or irinotecan combined with cetuximab. Radiation therapy may be used in place of chemotherapy or in combination with it. Studies indicate that chemotherapy offers only a modest improvement in survival, but may help reduce symptoms.

text continues below

Prognosis

Colorectal cancer is among the most curable of cancers when it is caught in its early stages. The term "5-year survival" means that patients have lived at least 5 years since diagnosis. The 5-year survival rate for colon cancer diagnosed and treated at stage I is 74%. The rates fall to 37 - 67% for stage II, 28 - 73% for stage II, and 6% for stage IV. However, there are other factors, including the appearance of cancer cells under the microscope, that can contribute to a patient's prognosis.

Follow-Up Monitoring

Doctors recommend follow-up testing to detect recurring cancer after the completion of treatment. General guidelines include:

Physical Examination. Most colorectal cancer recurrences happen within 3 years after surgery. Patients should see their doctors for a physical examination every 3 - 6 months for the first 2 years following surgery, every 6 months through the fifth year, and at the doctor's and patient's discretion during subsequent years.