Which stage of cancer is curable

Colon Cancer Diagnosis - What Can I Expect?

Dear patient,

You have been diagnosed with early-stage colon cancer. “Early” means that the cancer has not spread to other organs. Colon cancer can often be cured at an early stage. Nevertheless, a cancer diagnosis can be frightening and stressful. This brief information sheet tells you what colorectal cancer is and how it can be treated.

At a glance: colon cancer

  • Colon cancer in the early stages is when the cancer has not spread to other organs. Then it is often curable.
  • A distinction is made between cancer in the large intestine (colon) and cancer in the rectum. Different recommendations sometimes apply to both.
  • For colon cancer in the early stages, the experts recommend surgery.
  • Sometimes radiation or chemotherapy accompanying the operation can improve the chances of recovery.

How is colon cancer diagnosed?

If colon cancer is suspected, the doctor should perform a colonoscopy. He takes tissue samples from suspicious areas, which are then examined in the laboratory. If the suspicion of cancer is confirmed, further examinations clarify how far it has spread: Experts recommend an ultrasound of the abdomen, an X-ray of the lungs and a palpation of the rectum. In addition, the tumor marker CEA is to be determined in the blood. In the case of cancer of the rectum, further examinations are also carried out: a magnetic resonance tomography (MRI), an ultrasound of the rectum "from the inside" and a rigid reflection of the rectum. Other examinations are only recommended in isolated cases.

What does "early stage colon cancer" mean?

To find the right treatment, it's important to know how far the cancer has spread. To do this, it is divided into stages:
  • Stage I: The cancer is limited to the muscle layer of the intestine.
  • Stage II: The cancer has reached the outer layer of the intestinal wall or has grown into neighboring tissue.
  • Stage III: The cancer has affected the surrounding lymph nodes, but no other organs.
  • Stage IV: The cancer has affected other organs.
Stages I to III are called the early stages.

How is the disease progressing in the "early stage"?

The course of the disease is often favorable here. The lower the stage, the better the prospects. Approximately 5 years after diagnosis:
  • 95 out of 100 people with stage I colon cancer
  • 85 out of 100 people with stage II colon cancer
  • 60 out of 100 people with stage III colon cancer

How is early stage colon cancer treated?

In the early stages, the goal is to cure the disease. That is why the experts recommend an operation for stages I to III. The surgical team not only removes the section of the intestine that is affected by cancer. To be on the safe side, it also cuts out enough healthy tissue - a slightly larger part of the intestine.

Some people need an artificial anus (stoma) temporarily or permanently after the operation. If the cancer is in the rectum, most of those affected are temporarily put on such a stoma. The artificial anus remains permanent in around 1 to 2 out of 10 people who have been operated on. However, this is rare in patients with cancer of the colon. In addition to the operation, the experts recommend additional treatments in certain situations.

Complementary treatment for cancer of the colon

In certain situations, chemotherapy after surgery can improve the chances of recovery. The most important requirement is that the cancer has been completely removed. In addition, the following applies:
  • Stage III patients should receive concomitant chemotherapy. In high-quality studies, 10 to 14 out of 100 treated patients had a survival advantage as a result.
  • The data situation is not clear for patients in stage II. There is some evidence that additional chemotherapy may help some patients with aggressive cancer.
  • Stage I patients do not benefit from additional chemotherapy. You should therefore not receive any.

Complementary treatment for cancer of the rectum

In the case of cancer of the rectum, radiation therapy - also in conjunction with chemotherapy - can be used as a support. The following applies to the individual stages:
  • Patients in stage II and III should receive additional radiation before the operation, possibly in conjunction with chemotherapy (radiochemotherapy). Meaningful studies show that this can prevent some relapses. Radiation in conjunction with chemotherapy is somewhat more effective, but also has more side effects. These treatments work better before the operation than afterwards. They are also tolerated a little better. The studies could not show that they increase survival time. Anyone who received chemoradiotherapy before the operation should also receive chemotherapy after the operation.
  • Stage I patients do not benefit from complementary treatment. You should therefore not receive any.

What you can do yourself

  • Even if the sphincter is retained during the operation, it can cause problems with bowel movements. Be patient: it can take a few months, sometimes years, for these problems to improve. Pelvic floor exercises or physiotherapy can help.
  • Anyone who receives an artificial anus can usually learn to live with it. Many sufferers can go back to their everyday lives after a while. Travel, sport or physical work are also often possible. It can be helpful to speak openly about it with friends, colleagues, or in a support group.
  • If you are under severe emotional stress, you can take advantage of psycho-oncological help. Talk to your treating doctors about it.

Information sheet "Diagnosing Colon Cancer - What to Expect?"

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Source: Medical Center for Quality in Medicine (ÄZQ)