According to the American Cancer Society (ACS), colorectal cancer is the third leading cause of cancer death in the U.S. The ACS estimates nearly 137,000 Americans will be diagnosed with the disease this year and more than 50,000 will die from it.
Knowing these statistics, it is more important than ever to act as your own healthcare advocate when it comes to a colorectal cancer diagnosis. While it’s true that your physician has your best interests in mind, nobody knows your body as well as you do. By acknowledging your body’s warning signs and staying informed about the latest healthcare developments, you can help prevent yourself from becoming another colorectal cancer statistic.
As a physician and radiation oncologist, I have worked with many patients who each found themselves facing different stages of the cancer journey. With new treatments being developed and ever-changing screening guidelines, talking to your physician can be overwhelming. Over the years, I have noticed some common questions that most patients have. While the following questions and answers do not cover all of the topics you will need to discuss with your physician, they provide great discussion points to get the conversation started.
Q: At what point should I talk with my doctor about colon cancer?
A: Anytime one of your family members is diagnosed with cancer, you should let your personal physician know so your medical records are updated and your individual risk is assessed. Most of the time there is not a genetic link or increased risk for you, but it is always in your best interest to keep your medical records up to date as new information is learned.
Q: Once diagnosed with colon cancer, what are some of my potential treatment options?
A: At the beginning – when diagnosis is just made – a full ‘staging’ process is completed which involves finding out exactly where the cancer is and where it is not in the body. Once that is known, the most appropriate treatment options are discussed. These range from removing a cancerous polyp during colonoscopy, to receiving surgery with chemotherapy and radiation therapy. Treatments can be complicated, so it is most helpful to focus on the stage of your disease and not on all of the many options which would not be appropriate for your situation.
Q: What causes cancer to become metastatic?
A: It is not known for sure how tumor cells acquire the ability to escape the location in the colon and rectum where they formed. A cancer cell is most dangerous when it can survive outside the colon, i.e. liver, lymph nodes, lung, and where they also become more difficult to kill with chemotherapy and radiation treatments.
Q: When colon cancer becomes metastatic, what are the chances of survival?
A: Survival after the spread of colorectal cancers to other parts of the body has increased dramatically in the past decade. Although most patients cannot be ‘cured’ to the point where they never have that cancer again, a few situations do exist where this is possible. One example is colorectal cancer that has spread to only a portion of the liver. Surgical removal of that part of the liver can be curative. These patients should continue regular monitoring with their physician as there is a high likelihood of recurrence.
Q: Can diet positively affect outcomes when battling colon cancer?
A: Yes – the needs of your body change when receiving active therapy such as chemotherapy or radiation treatment. Damage to the normal cells and an increased work load of the body to rid itself of dying cancer cells; contribute to an increased need for protein and calories in general to fuel repairs. Many cancer patients unfortunately lose their appetite during treatment as a result of the cancer and also as a side effect of treatment – right when they need to have a balanced but high protein diet the most. This is an important time to see a nutrition expert.
Q: When does Selective Internal Radiation Therapy (SIRT) become a good treatment option?
A: Treating the liver with radiation is indicated when a surgery to remove the tumors is not possible and most of the known metastatic cancer resides in the liver. Chemotherapy has often been given for many months and should continue to be part of the treatment schedule even if SIRT is used in the liver. It is important that the function of the liver is good prior to considering implanting radiation into the tumors in the liver. If it is, then SIRT can be a helpful and important treatment for most patients with metastatic colorectal tumors to the liver as part of a comprehensive treatment team approach involving medical oncology, surgical oncology, interventional radiology, nuclear medicine and diagnostic radiology, to name a few.
Q: What are some factors that would make SIRT a poor treatment option?
A: Liver-directed radiation is not helpful in patients whose liver is not working well, those with more tumors outside the liver than in the liver, patients who have not yet tried best chemotherapy treatments or patients who have not yet had surgery to remove tumors in the liver when that option is considered appropriate.
Facing a cancer diagnosis is scary, but you don’t have to feel helpless. There are many ways to stay informed about treatment options for colorectal cancer. In addition to having a candid chat with your physician, you can search the web, tap into advocacy groups or join a patient support group. Either way, I encourage you to learn as much as you can about treatment options to make the right decision for yourself.
About Dr. Andrew Kennedy, MD
Dr. Andrew Kennedy is an internationally-renowned radiation oncologist specializing in gastrointestinal cancers, as well as cancers of the breast and lung. He is a graduate of the Loma Linda University School of Medicine in California and completed his residency at The University of North Carolina at Chapel Hill. Dr. Kennedy has given hundreds of presentations on radiation therapy for the treatment of colorectal and liver cancers worldwide, and has been selected as one of America’s Best Doctors (top 5% of the U.S.) annually since 2009. Click here for Dr. Kennedy’s full biography.
Don’t forget, the Colon Cancer Alliance serves as a source of information about colon health. If you have questions or are in need of support, please contact our free Helpline at (877) 422-2030. We’re here to help!