Colon Cancer information

This is not a substitute for direct care by YOUR doctor. Confirm with your doctor before doing any of the following.

1. What stage am I?

This is difficult to know before the cancer is removed. Stage 4 means that the

cancer has spread beyond the colon and typically is diagnosed on CT (computed

tomography) scan. Unless you have Stage 4 or early Stage 1 cancer (cancer

only in the very innermost layer of the colon), the final stage cannot be

determined until tumor is removed during surgery, and the lymph nodes are

examined.

2. How is colon cancer treated?

Very early colon cancer can be treated with colonoscopy polyp removal. Stage 2

and Stage 3, as well as some Stage 1, colon cancers are treated with surgery.

Stage 4 is treated with chemotherapy first typically.

3. Will I need chemotherapy?

Generally, all patients with Stage 3 and Stage 4 cancers are recommended to

get chemotherapy after surgery. Some patients with Stage 2 are also

recommended to get chemotherapy.

4. Will I need an ostomy (bag)?

When surgery is planned (i.e. not an emergency), most patients can be "put

back together." Surgeons do not like giving patients ostomies, but sometimes it

is the safest thing to do. Ostomies are frequently not permanent and may be

able to be reversed. The timeframe to reverse an ostomy can depend on multiple

factors and should be discussed with your surgeon.

5. What is all of this testing that I am getting?

Before surgery, you need a colonoscopy (which is probably how the cancer was

diagnosed). You will need a CT scan of the chest, abdomen, and pelvis to look for

cancer outside of the bowel. You will need a lab test called "CEA." CEA

(carcinoembryonic antigen) is something that we look at after surgery as a

marker of worsening cancer. If your CEA goes up, then we know to be more

concerned that the cancer may be back, and we need to do more testing.

6. Are my children at a higher risk of cancer?

Yes. Any first degree relative (children, siblings, parents) of a person with colon

cancer should undergo colonoscopy (not Cologuard testing) every five years

instead of every ten years. They should also start at 10 years before your cancer

was diagnosed or at 40 years old (whichever is younger).

7. Am I going to be okay?

Cancer is a very scary thing. The most important thing in figuring out survival

likelihood is what stage you are at. There are a lot of different factors that go

beyond stage though. These include: the tumor DNA / genetic factors, how

healthy you are to begin with, if you complete treatment, etc.

There are things that you can do to help your health. Treatment makes all of

these things more difficult, so just do your best. Even trying some of these can

help (regardless of how successful you are at them).

Here are some recommendations:

• If you are a smoker – QUIT NOW

• Exercise if you can.

• Try to eat well. This does not mean that you have to be perfect or that all of

your food must be organic or fresh or a special diet. This means that you

should try to eat a good variety of fruits, vegetables, and protein.

• Friends and family help a great deal. Support groups can offer you

encouragement. Your mental health can make a big difference. Let your medical team know

if we can do something to help you during this stressful time.

8. How is my surgery done?

Most patients undergo minimally invasive surgery. This refers to either

laparoscopic or, more commonly, robotic surgery using small incisions and a

camera. If it is not safe to do surgery through small incisions, a larger incision

will need to be made. This is uncommon but does happen.

9. How long will I be in the hospital?

Usually, 2-4 days, depending on the kind of surgery and how you recover.

Before being discharged from the hospital, you need to have your pain well

controlled, tolerate a diet, and have a bowel movement.

10. Do I need to eat a special diet when I come home? Will I be “normal” or have normal bowel funct

You can eat whatever is comfortable for you. This is probably not the time to

start a new and/or exciting food. Most patients will eventually return to their

normal bowel habits. Patients undergoing "right" or ascending colon surgery

are more likely to have diarrhea after surgery. It also takes time for your bowel

to adjust after surgery. This can continue for up to 6 months but may happen

right away in some patients. Fiber supplementation can help. Make sure to

drink plenty of water when taking fiber and increase your fiber intake

gradually to avoid bloating. Anything that is concerning to you is something

you should bring up to your doctor.

https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1428

https://colorectalcancer.org/resources-support

https://staging.fascrs.org/ascrs/media/files/downloads/Clinical%20Practice%20Guidelines/cpg_treatment_of_colon_cancer.pdf