If a polyp that was removed during a colonoscopy is found to be cancerous, there are several things that typically happen next. The main questions that need to be answered are: 1) Has the cancer spread beyond the polyp site? 2) What stage and grade is the cancer? 3) What treatment is recommended?
Further Testing to Determine if Cancer Has Spread
Once a polyp is found to contain cancer, further testing is done to see if the cancer has spread beyond the site of the polyp. This helps determine the stage of the cancer. Some common tests include:
- CT scan of the abdomen and pelvis – This looks for any cancer spread to lymph nodes and other organs.
- Chest x-ray – Checks the lungs for cancer spread.
- PET scan – A PET scan uses radioactive glucose to look for cancer spread throughout the body.
- Blood tests – Certain blood tests like CEA levels can be indicators of cancer spread.
Based on these test results, the cancer will be assigned a stage – stage I, II, III, or IV. The higher the stage, the more the cancer has spread beyond the colon.
Determining the Grade of the Cancer
In addition to the cancer stage, the grade of the cancer cells is also important. Cancer grade refers to how abnormal the cancer cells look under a microscope. There are three grades:
- Grade 1 (G1): The cancer cells look much like normal cells. They tend to grow slowly.
- Grade 2 (G2): The cells look somewhat abnormal. They grow somewhat faster than G1 cells.
- Grade 3 (G3): The cancer cells look very abnormal. They grow rapidly.
A higher grade indicates faster growing, more aggressive cancer. Grade along with stage helps determine prognosis and treatment options.
Treatment Recommendations
Once the stage and grade are known, the cancer care team will make treatment recommendations. Common treatments include:
- Surgery – Often more extensive surgery is done to remove a section of the colon and nearby lymph nodes.
- Chemotherapy – Chemotherapy uses anti-cancer drugs to kill cancer cells. It may be given after surgery to try to kill any remaining cancer cells.
- Radiation – Radiation therapy uses high energy beams to kill cancer cells. It is sometimes used after surgery.
- Targeted therapy – Some drugs target specific genes or proteins found in cancer cells.
Treatment depends on the stage and grade of the cancer. Early stage cancers may only require surgery, while later stage cancers often need chemo and/or radiation after surgery. Your doctor will explain your options.
What is the Prognosis if the Polyp Was Cancerous?
The prognosis or outlook for colon cancer depends on the stage and grade:
| Stage | 5-Year Relative Survival Rate |
|---|---|
| Stage I | 92% |
| Stage IIA | 87% |
| Stage IIB | 63% |
| Stage IIC | 63% |
| Stage IIIA | 89% |
| Stage IIIB | 69% |
| Stage IIIC | 53% |
| Stage IVA | 18% |
| Stage IVB | 6% |
As the table shows, early stage colon cancers have a very favorable outlook with over 90% of stage I patients surviving long-term. More advanced stage IV colon cancers have a poorer prognosis.
Coping Emotionally After a Cancer Diagnosis
Being diagnosed with cancer is frightening and stressful. Some tips for coping:
- Learn all you can about your cancer and treatment options.
- Join a support group to connect with others going through similar situations.
- Communicate openly with your care team and loved ones about your feelings.
- Use relaxation techniques like meditation to reduce anxiety.
- Eat a healthy diet and stay active – this can lift your mood.
- Avoid negative self-talk and remain hopeful.
- Seek counseling or anti-anxiety medication if you are struggling with depression.
It’s normal to feel scared, sad, or angry after a cancer diagnosis. Give yourself permission to experience these emotions. Stay connected with your support system. You don’t have to go through this alone.
Steps to Take After Finding Out You Have Colon Cancer
If colon cancer is diagnosed, here are some important steps to take:
- Learn about your cancer specifics – stage, grade, subtype. Understanding your diagnosis allows you to make informed treatment decisions.
- Get a second opinion. Having another cancer specialist review your case can provide reassurance or new perspectives.
- Have any recommended genetic testing. If you have lynch syndrome, family members may need screening.
- Discuss all treatment options with your care team. Consider pros/cons, side effects, costs.
- Ask about clinical trials you may qualify for.
- Line up social and financial support. Get help from friends, family, support groups.
- Connect with a dietitian to optimize nutrition.
- Look into complementary therapies to support your care such as meditation, massage.
- Stay focused on the present. Dwelling on fears about the future adds stress.
- Share your feelings openly. Don’t isolate yourself emotionally.
Despite the difficulties involved, many people with colon cancer go on to live active, fulfilling lives. Recent treatment advances have improved survival. Focus on staying positive and know there are many people who will support you each step of the way.
Can Colon Cancer Come Back After Treatment?
Unfortunately, there is always a chance that colon cancer can recur after initial treatment. According to the American Cancer Society, about 1 in 3 early-stage colon cancers come back within the first 5 years after treatment. Some factors that raise risk of recurrence include:
- Lymph nodes involvement – Cancer in nearby lymph nodes is associated with higher recurrence rates.
- Higher cancer stage – Later stage disease is more likely to return than early stage.
- Cancer at resection margins – Positive margins mean cancer cells at the edge of removed tissue.
- Poorly differentiated tumors – High grade tumors recur more frequently.
To watch for potential recurrences, your doctor will establish a followup plan after you finish treatment. This usually includes:
- Physical exam every 3-6 months for several years
- CarCEA blood test every 3-6 months
- Colonoscopy within 1 year of surgery, then every 3-5 years
- CT scan every 6-12 months for up to 5 years
Make sure to keep up with these surveillance tests so any recurrence can be detected early. Let your care team know right away about concerning symptoms like blood in the stool, abdominal pain, unexplained weight loss, or fatigue.
Treating Recurrent Colon Cancer
If colon cancer does return, treatments will depend on:
- Where the cancer has recurred
- What treatments you’ve already had
- Your overall health
More surgery may be done to remove areas of recurrence. Radiation and chemo may be options as well, potentially using newer targeted drugs. Immunotherapy is also showing promise. In serious cases, palliative care helps relieve symptoms and improve quality of life. You can count on your care team to support you every step of the way.
Leading a Healthy Lifestyle After Colon Cancer Treatment
Making certain lifestyle changes after colon cancer treatment may help lower the risk of recurrence and improve wellbeing overall. Recommendations include:
- Eating a balanced, low-fat, high-fiber diet – Emphasize plenty of fruits/veggies, whole grains, beans/legumes.
- Exercising regularly – Aim for at least 150 minutes per week of moderate activity like brisk walking.
- Achieving/maintaining a healthy body weight – Being overweight is linked to higher recurrence risk.
- Limiting red/processed meats – Eat no more than 18 oz of red meat per week.
- Don’t smoke – Smoking makes cancer recurrence more likely. Get help quitting.
- Drink alcohol moderately, if at all – Heavy drinking is associated with recurrence.
- Manage stress – Stress-reducing practices like yoga help quality of life.
Check with your care team for any other lifestyle suggestions that may specifically benefit you. Adhering to national guidelines for nutrition, exercise, and weight not only improves colon cancer outcomes but also optimizes your overall health.
Questions to Ask Your Doctor After Colon Cancer Diagnosis
Some questions to ask your doctor after being diagnosed with colon cancer include:
- What is the exact stage and grade of my cancer? How does this affect my prognosis?
- Do I need genetic testing for things like Lynch Syndrome?
- What are my treatment options? What do you recommend and why?
- What are the benefits and risks with each treatment option?
- How much experience do you have treating this type of cancer?
- Should I get a second opinion?
- How will this treatment affect my daily life?
- What are the chances the cancer will recur?
- What follow up tests will I need after treatment? How often?
- Are there any clinical trials I should consider?
Don’t hesitate to bring a list of questions to your appointments. It’s understandable to have lots of concerns after a colon cancer diagnosis. Asking your doctor questions will help empower you to make informed decisions about your care.
Conclusion
Being diagnosed with colon cancer can be scary. But current treatments allow many people to enjoy long-term cancer-free survival. Understanding your diagnosis, evaluating all your treatment options, and following your doctor’s advice for surveillance and lifestyle changes are important steps to take after colon cancer is found. With each advancement in colon cancer research, there is more reason to be hopeful for the future.