You did the right thing and scheduled your colonoscopy. You prepped well, showed up for your appointment on time, realized it wasn’t that bad of a procedure, and put it out of your head until your GI doctor gave you the call with the news you didn’t expect to hear—a diagnosis of colon cancer. You’re likely in a bit of shock. Maybe you blocked out a bit of what the physician is saying to you. What happens next? One of the first things that’s necessary for understanding the next steps is knowing what type of colon cancer you have, what stage it’s in, and what treatments are available to you. 

What Is Colon Cancer, Exactly?


You may hear the terms colon cancer and colorectal cancer used interchangeably when in reality, they shouldn’t be. Be sure to ask your doctor exactly what type of cancer you have. Colon cancer is cancer found in the colon, rectal cancer is found in the rectum, and colorectal cancer is found in both. Later-stage colorectal cancer can metastasize and spread to other parts of the body, such as the liver. When colon or colorectal cancer first begins, it starts as a growth called a polyp. If you have colon cancer in the early stages, your doctor can often remove precancerous or cancerous polyps during the colonoscopy before they spread and become dangerous. There are several different types of colon and colorectal cancer, but the most common type is adenocarcinoma.  

How Serious Is My Cancer?


This is, of course, the most prevalent question on your mind. Colon cancer is divided into stages from 0 through IV, with substages within the stages. The system that physicians use to stage colon cancer is known as the TNM system. T stands for the primary tumor; your doctor will measure the extent and size of the largest polyp. N refers to your lymph nodes—your doctor checks to see if cancer has spread to any of the lymph nodes. Lastly, M is for metastasize, to see if the cancer has spread to any other part of the body other than the colon and rectum. While this may sound simple, this is a complex system your doctor uses based on your pathology report. If you tried to read the results of the TNM system yourself, it may be a bit confusing, so it’s much easier to understand the breakdown of colon cancer stages in a simpler way:

  • Stage 0: In situ. This means there are cancer cells present but no real growth.
  • Stage I: The cancer has grown and spread to the colon or rectum but not to other parts of the body.
  • Stage IIA: The cancer has grown past the wall of the colon or rectum but still has not spread to lymph nodes or other parts of the body.
  • Stage IIB: The cancer has spread to the abdomen (visceral peritoneum) but has not spread to anywhere else.
  • Stage IIC: The cancer has pressed through the wall of the colon and rectum and to nearby structures but has not invaded the lymph nodes as of yet.
  • Stage IIIA: The cancer has to spread to one to three lymph nodes.
  • Stage IIIB: The cancer has spread to several lymph nodes and tissues but not to other parts of the body.
  • Stage IIIC: The cancer has spread to four or more lymph nodes. 
  • Stage IVA: The cancer has metastasized and spread to the liver or lungs.
  • Stage IVB: The cancer has spread to multiple parts of the body. 
  • Stage IVC: The cancer has spread to the peritoneum as well as multiple parts of the body.

The Stages of Colon Cancer

As you can see, colorectal cancer gradually spreads, so it’s important to hear from your doctor at what stage they have diagnosed you. Stages 0 through II are highly treatable, but there are treatment options for stages III and IV as well. 

What Are My Treatment Options?


The next question you should be asking your gastroenterologist after your colonoscopy is what your treatment options are. If you have an early-stage colon cancer diagnosis, you may have been able to have precancerous polyps removed during your colonoscopy, and you may have to schedule regular colonoscopies and checkups to ensure there is no new growth. 

For those who have colon cancer that has spread to the lymph nodes, quite often the lymph nodes are surgically removed. This is accomplished by removing two parts of the non-cancerous colon on each side, surgically removing the lymph nodes, and replacing the colon. 

If a patient has rectal cancer, a different type of intervention is needed. They will most likely have to undergo chemotherapy and radiation prior to surgery, and the cancerous part of the rectum must be removed in order to treat the cancer. If the colorectal cancer has metastasized, then part of the bladder, prostate, or uterus may need to be removed as well. In these cases, patients will require a colostomy (to help rid the body of feces) and a urostomy (to help rid the body of urine), depending on what type of intervention was needed. 

While surgery is often the first-line treatment for colorectal cancer, your doctor may suggest chemotherapy or radiation, depending on your particular case and the stage of your cancer. Radiation may be used after surgery to kill cancer cells not seen by the naked eye or may be used in lieu of surgery. What radiation does is use high-energy rays (something similar to an X-ray), and the rays kill the cancer cells, often preventing them from returning. Radiation does have some side effects, such as nausea and fatigue, but it can be very helpful in colon cancer treatment. 

Chemotherapy is another option when it comes to colon cancer treatment. This treatment is usually administered intravenously through an IV or by medication taken by mouth. This treatment may also be an option post-surgery or may be used in place of surgery. It may also be combined with radiation in a process known as chemoradiation.

Your physician may also opt to use immunotherapy, which boosts your immune system or targeted therapy, which are medications used to treat cancer that are different from chemotherapy, as part of your treatment. Be sure and ask as many questions as possible to be completely involved in your colon cancer treatment. 

The best thing to do once you receive a colon cancer diagnosis from your GI doctor after a colonoscopy is not to panic but to set up another visit and discuss treatment right away. Early detection of colon cancer means you have more treatment options available with a higher success rate of complete cancer removal. If you need more information about how to proceed after a colon cancer diagnosis or want to make an appointment for a colonoscopy so you can get a screening for colon cancer, make an appointment at Carolina Digestive Health Associates today. Don’t put off screenings or follow-up appointments—both colonoscopy and early detection are vitally important and save lives.