Cancer

What is the follow-up care for colon cancer?

Follow-up exams are important after treatment for colon cancer. The cancer can recur near the original site or in a distant organ such as the liver or lung. Follow-up exams include a physical examination by the doctor, blood tests of liver enzymes, chest x-rays, CAT scans of the abdomen and pelvis, colonoscopies, and blood CEA levels. Abnormal liver enzymes may indicate growth of liver metastasis. CEA levels may be elevated before surgery and become normal shortly after the cancer is removed. Slowly rising CEA level may indicate cancer recurrence. A CAT scan of the abdomen and pelvis can show tumor recurrence in the liver, pelvis, or other areas. Colonoscopy can show recurrence of polyps or cancer in the large intestine.

In addition to checking for cancer recurrence, patients who have had colon cancer may have an increased risk of cancer of the prostate, breast, and ovary. Therefore, follow-up examinations should include these areas.

What does the future hold for patients with colorectal cancer?

Colon cancer remains a major cause of death and disease, especially in the western world. A clear understanding of the causes and course of the disease is emerging. This has allowed for recommendations regarding screening for and prevention of this disease. The removal of colon polyps helps prevent colon cancer. Early detection of colon cancer can improve the chances of a cure and overall survival. Treatment remains unsatisfactory for advanced disease, but research in this area remains strong and newer treatments continue to emerge. New and exciting preventive measures have recently focused on the possible beneficial effects of aspirin or other anti-inflammatory agents. In trials, the use of these agents has markedly limited colon cancer formation in several experimental models. Other agents being evaluated to prevent colon cancer include calcium, selenium, and vitamins A, C, and E. More studies are needed before these agents can be recommended for widespread use by the public to prevent colon cancer.

Colon Cancer At A Glance

• Colorectal cancer is a malignant tumor arising from the inner wall of the large intestine.
• Colorectal cancer is the third leading cause of cancer in males and fourth in females in the U.S.
• Risk factors for colorectal cancer include heredity, colon polyps, and long-standing ulcerative colitis.
• Most colorectal cancers develop from polyps. Removal of colon polyps can prevent colorectal cancer.
• Colon polyps and early cancer can have no symptoms. Therefore regular screening is important.
• Diagnosis of colorectal cancer can be made by barium enema or by colonoscopy with biopsy confirmation of cancer tissue.
• Treatment of colorectal cancer depends on the location, size, and extent of cancer spread, as well as the age and health of the patient.
• Surgery is the most common treatment for colorectal cancer.