Designed and created by Guideline Central in participation with the American Society of Colon and Rectal Surgeons
Management of Colon Cancer
Patient Guideline Summary
Publication Date: January 17, 2022
Last Updated: March 3, 2023
Objective
Objective
This patient summary means to discuss key recommendations from the American Society of Colon and Rectal Surgeons (ASCRS) for colon cancer. It is limited to adults 18 years of age and older and should not be used as a reference for children.
Overview
Overview
- Colon cancer occurs most commonly over 50 years of age. It is best diagnosed by screening.
- There are no known causes, but certain hereditary conditions increase its incidence.
- Early symptoms include a change in bowel habits and blood in the stool.
- This patient summary focuses on surgical management of colon cancer.
Diagnosis
Diagnosis
- All serious diseases require a thorough evaluation. For colon cancer these are included:
- Carcinoembryonic antigen (CEA)
- Colonoscopy with biopsy-proved cancer
- Computed tomography (CT) or magnetic resonance imaging (MRI) of the chest, abdomen, and pelvis
- Tumor, Node, Metastasis Staging
- Possibly positron emission tomography (PET)/CT
Treatment
Treatment
- It is rare for cancer treatment to proceed without multidisciplinary consultation involving experts in every related specialty.
- A wide variety of surgical procedures is available depending on the extent of cancer and the surgical expertise available.
- Some localized cancers can be removed through an endoscope.
- More extensive cancers require a thorough exploration of the entire abdomen.
- Sometimes a colostomy (an opening through the abdominal wall through which the bowel empties, requiring a bag to catch the stool) is required.
- A colostomy may be temporary, taken down at a subsequent operation.
- Neoadjuvant treatment (chemotherapy or radiotherapy before surgery) may reduce tumor mass, making complete resection more likely.
- Cancers initially judged to be unresectable may become resectable following neoadjuvant treatment.
- If complete removal of the cancer is not possible, surgery may still be needed to deal with bleeding, obstruction, or perforation of the bowel.
- Surgery may also be helpful or necessary for distant metastases (pieces of original cancer in other locations) that are causing symptoms.
- Chemotherapy after surgery (adjuvant), generally begun within 8 weeks of surgery, maybe the best option for cancer that couldn’t be removed surgically but is or will be symptomatic.
- Immunotherapy has proved effective for certain types of colon cancer.
- Gene analysis may help guide treatment decisions.
Abbreviations
- ASCRS: American Society Of Colon And Rectal Surgeons
- CEA: Carcinoembryonic Antigen
- CT: Computed Tomography
- MRI: Magnetic Resonance Imaging
- PET: Positron Emission Tomography
Source Citation
Vogel JD, Felder SI, Bhama AR, Hawkins AT, Langenfeld SJ, Shaffer VO, Thorsen AJ, Weiser MR, Chang GJ, Lightner AL, Feingold DL, Paquette IM. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colon Cancer. Dis Colon Rectum. 2022 Feb 1;65(2):148-177. doi: 10.1097/DCR.0000000000002323. PMID: 34775402.
Disclaimer
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.