When colon cancer is suspected your doctor will do a basic set of blood tests that may include tumour markers called CEA. You will be referred to have a colonoscopy, which will visualise the entire colon and biopsies will be taken if there is a cancerous growth.
Once colon cancer is proved, certain tests are required to determine the stage of the cancer, which helps to determine the appropriate treatment.
1. CT scan of the abdomen and chest to determine whether the cancer has spread to the liver and/or lungs. It may also demonstrate lymph nodes spread to some extent
2. PET scan: this is a form of nuclear medicine scan, the main purpose of the PET scan is ensure there is no spread to other organs
3. MRI of the liver: this will be requested if there are liver metastases to confirm the number of the lesions and their location in relation to main vascular structures.
The stages of colon cancer are:
- Stage I: cancer has grown through and limited to the superficial lining of the bowel.
- Stage II: cancer has grown into or through the muscular wall of the colon without spread to lymph nodes.
- Stage III: cancer has spread to the lymph nodes
- Stage IV: cancer has spread to other organs such as the liver or the lungs
1. Removal of small cancer by colonoscopy in the very early stages
2.Endoscopic mucosal resection: larger polyps may be removed along with a small area of the bowel inner lining
6. Surgery for metastatic disease to the liver and lungs: in stage four disease surgery is still an option particularly if the spread was in the liver and/or lungs. Usually you will need chemotherapy and are then referred to a Hepatobiliary surgeon for consultation to find out if the liver disease is removable, also a chest surgeon may be able to remove cancer that has spread to the lungs.