colon cancer symptom

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Friday, June 23, 2006

colon cancer symptom : Treatment

Treatment depends partly on the stage of the cancer. This means how far the tumor has spread through the layers of the intestine, from the innermost lining to outside the intestinal wall and beyond:

Stage 0: Very early cancer on the innermost layer (more accurately considered a precursor to cancer)
Stage I: Tumor in the inner layers of the colon
Stage II: Tumor has spread through the muscle wall of the colon
Stage III: Tumor that has spread to the lymph nodes
Stage IV: Tumor that has spread to distant organs
Stage 0 colon cancer may be treated by cutting out the lesion, often via a colonoscopy. For stages I, II, and III cancer, more extensive surgery to remove a segment of colon containing the tumor and reattachment of the colon is necessary. (See colon resection.) This procedure only rarely requires a colostomy.

Almost all patients with stage III colon cancer, after surgery, should receive chemotherapy (adjuvant chemotherapy) with a drug known as 5-fluorouracil given for approximately 6 - 8 months. This drug has been shown to increase the chance of a cure. There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery, and patients should discuss this with their oncologist.

Chemotherapy is also used for patients with stage IV disease in order to shrink the tumor, lengthen life, and improve the patient's quality of life. Irinotecan, oxaloplatin, and 5-fluorouracil are the 3 most commonly used drugs, given either individually or in combination. There are oral chemotherapy drugs which are similar to 5-fluroruracil, the most commonly used being capecitabine (Xeloda).

Oxaliplatin, a newer chemotherapy drug, was approved by the FDA in 2002 and is also active against colon cancer. It is often used in combination with 5-fluorouracil, and studies are being done that combine it with other chemotherapy drugs. Other chemotherapy agents, including drugs that specifically target abnormalities in cancer cells, are currently in development and undergoing clinical trials.

For patients with stage IV disease that is localized to the liver, various treatments directed specifically at the liver can be used. Tumors may be surgically removed, burned, or frozen in some cases. Chemotherapy or radioactive substances can sometimes be infused directly into the liver.

Radiation therapy is occasionally used in patients with colon cancer, but this is often used in combination with chemotherapy for patients with stage III rectal cancer.

If the patient's colon cancer does not come back (recur) within 5 years, it is considered cured. This is because colon cancer rarely comes back after 5 years. Stage I, II, and III cancers are considered potentially curable. In most cases, stage IV cancer is not curable.

Stage I has a 90% 5-year survival. Stage II has a 75 - 85% 5-year survival, and Stage III a 40 - 60% 5-year survival. These numbers take into account that for stage III patients (and in some studies, stage II patients), chemotherapy improves the chance of 5-year survival.

Patients with stage IV disease rarely live beyond 5 years, and the median survival (meaning half the patients live longer, and half shorter) with treatment is between 1 and 2 years.

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