Sunday, February 25, 2024

Life Expectancy With Colon Cancer

Ask Your Doctor For A Survivorship Care Plan

Understanding Metastatic Colon Cancer

Talk with your doctor about developing a survivorship care plan for you. This plan might include:

  • A suggested schedule for follow-up exams and tests
  • A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
  • A schedule for other tests you might need in the future, such as early detection tests for other types of cancer
  • Suggestions for things you can do that might improve your health, including possibly lowering your chances of the cancer coming back, such as diet and physical activity changes
  • Reminders to keep your appointments with your primary care provider who will monitor your general health care, including your cancer screening tests.

Ajcc Stage Groupings And Tnm Definitions

The AJCC has designated staging by TNM classification to define colon cancer. The same classification is used for both clinical and pathologic staging.

Table 1. Definitions of TNM Stage 0a

Stage Illustration
T = primary tumor N = regional lymph nodes M = distant metastasis.
aReprinted with permission from AJCC: Colon and rectum. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp 25174.
The explanations for superscripts b and c are at the end of Table 5.
0 Tis, N0, M0 Enlarge
N0 = No regional lymph node metastasis.
M0 = No distant metastasis by imaging, etc. no evidence of tumor in distant sites or organs.
Table 2. Definitions of TNM Stage Ia

Stage Illustration
T = primary tumor N = regional lymph nodes M = distant metastasis.
aReprinted with permission from AJCC: Colon and rectum. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer, 2017, pp 25174.
The explanations for superscripts b and c are at the end of Table 5.
I
T2 = Tumor invades the muscularis propria.
N0 = No regional lymph node metastasis.
M0 = No distant metastasis by imaging, etc. no evidence of tumor in distant sites or organs.
References
  • Jessup J, Benson A, Chen V: Colon and Rectum. In: Amin MB, Edge SB, Greene FL, et al., eds.: AJCC Cancer Staging Manual. 8th ed. Springer 2017, pp 25174.
  • Treatment Of Liver Metastasis

    Approximately 50% of colon cancer patients will be diagnosed with hepatic metastases, either at the time of initial presentation or because of disease recurrence. Although only a small proportion of patients with hepatic metastases are candidates for surgical resection, advances in tumor ablation techniques and in both regional and systemic chemotherapy administration provide for several treatment options. These include the following:

    Surgery

    Hepatic metastasis may be considered to be resectable based on the following factors:

    • Limited number of lesions.
    • Lack of major vascular involvement.
    • Absent or limited extrahepatic disease.
    • Enough functional hepatic reserve.

    For patients with hepatic metastasis that is considered to be resectable, a negative margin resection resulted in 5-year survival rates of 25% to 40% in mostly nonrandomized studies, such as the North Central Cancer Treatment Group trial . Improved surgical techniques and advances in preoperative imaging have improved patient selection for resection. In addition, multiple studies with multiagent chemotherapy have demonstrated that patients with metastatic disease isolated to the liver, which historically would be considered unresectable, can occasionally be made resectable after the administration of chemotherapy.

    Neoadjuvant chemotherapy for unresectable liver metastases

    Local ablation

    Adjuvant or neoadjuvant chemotherapy for resectable liver metastases

    Evidence :

  • There was no difference in DFS or OS .
  • Evidence :

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    Purpose Of This Summary

    This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of colon cancer. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions.

    Colon Cancer Survival Rate

    Stage 3 Colon Cancer Survival Rate By Age

    The colon cancer survival rate is encouragingly high more than 92 percent of patients diagnosed with stage 1 colon cancer live for at least five years after diagnosis. The survival rates for more advanced stages have been steadily increasing as well, due primarily to the availability of more effective treatment options and an increasingly better understanding of the disease as time goes on.

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    Living As A Colorectal Cancer Survivor

    For many people with colorectal cancer, treatment can remove or destroy the cancer. The end of treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. This is very common if youve had cancer.

    For other people, colorectal cancer may never go away completely. Some people may get regular treatment with chemotherapy, radiation therapy, or other treatments to try to control the cancer for as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.

    Where Do These Numbers Come From

    The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.

    The SEER database tracks 5-year relative survival rates for colon and rectal cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:

    • Localized: There is no sign that the cancer has spread outside of the colon or rectum.
    • Regional: The cancer has spread outside the colon or rectum to nearby structures or lymph nodes.
    • Distant: The cancer has spread to distant parts of the body such as the liver, lungs, or distant lymph nodes.

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    The Five Stages Of Colon Cancer

    Within each of the three categories, the cancer is classified even further and assigned a number and letter to indicate the extent of the disease. These assignments are based on the structure of the colon and how far the cancer has grown through the layers of the colon wall.

    The stages of colon cancer are as follows:

    Doctor Visits And Tests

    What Is Life Expectancy After Colon Removal?

    If there are no signs of cancer remaining, many doctors will recommend you have a physical exam and some of the tests listed below every 3 to 6 months for the first couple of years after treatment, then every 6 months or so for the next few years. People who were treated for early-stage cancers may do this less often.

    Colonoscopy

    In most cases, your doctor will recommend you have a colonoscopy about a year after surgery. If the results are normal, most people wont need another one for 3 years. If the results of that exam are normal, then future exams often can be about every 5 years. If the colonoscopy shows abnormal areas or polyps, the test may be needed more often.

    Proctoscopy

    If you had rectal cancer that was removed with a transanal excision , your doctor will likely recommend you have a proctoscopy every 3 to 6 months for the first couple of years after treatment, then every 6 months or so for the next few years. This allows the doctor to get a close look at the area where the tumor was to see if the cancer might be coming back.

    Imaging tests

    Whether or not your doctor recommends imaging tests will depend on the stage of your cancer and other factors. CT scans may be done regularly, such as once every 6 months to a year, for those at higher risk of recurrence, especially in the first few years after treatment. People who had tumors in the liver or lungs removed might be scanned every 3 to 6 months for the first few years.

    Blood tests for tumor markers

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    Whats The Rectal Cancer Survival Rate

    The overall five-year survival rate for rectal cancer is 63%. This means that people who have rectal cancer are about 63% as likely to be alive in five years as people who dont have rectal cancer. The five-year survival rate for localized rectal cancer is 91%. This means that people who have early stage rectal cancer are about 91% as likely to be alive in five years as people who dont have rectal cancer.

    Keep in mind that survival rates are estimates based on people who have had rectal cancer in the past. They cant predict what will happen or how long you will live. To learn more about rectal cancer survival rates, talk with your healthcare provider.

    Enhancing Healthcare Team Outcomes

    an interprofessional team including physician/nursing staff, nutritionist/dietitian, palliative service, social worker and case manager should be invited to participate and contribute in all new CRC diagnosis, treatment, and survivorship patient care. Screening for colorectal cancer is essential to identify premalignant lesions which have been shown to reduce the mortality of this disease but currently is underutilized.

    Extended third-generation, blood-relative, family history pedigree from CRC patients can identify those at risk of an unrecognized hereditary syndrome and further offer early and aggressive screening on survivors own risk and family members.

    For all CRC patients during and after completion of treatment, a discussion on lifestyle changes, including to follow a healthy diet, obtain and maintain ideal body weight, establish an active exercise routine, minimize alcohol consumption and quitting smoking, should be encouraged.

    CRC patients should be regularly screened for early identification of symptoms of psychosocial stress and offer early preventive interventions that would improve the quality of life and reduce suffering.

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    Sexuality And Feeling Good About Your Body

    Learning to be comfortable with your body during and after colorectal cancer treatment is a personal journey, one that is different for everyone. Some people may feel self-conscious if they have a colostomy or ileostomy as a result of treatment. Some people may have sexual problems as a result of the type of surgery they had for their cancer. Information and support can help you cope with these changes over time. Learn more in Sexuality for the Man With Cancer or Sexuality for the Woman With Cancer.

    How Is It Treated Or Managed

    Stage 4 Colon Cancer Prognosis

    The treatment for late-stage colorectal cancer may include systemic chemotherapy, new immunotherapies, or targeted radiotherapy. All these options aim to reduce the number of cancer cells, thereby improving your symptoms. Immunotherapies harness your immune system to destroy cancer cells. Many patients are given two or three of these drugs.

    Surgery is not typically an option at this point, although surgery to remove tumors from the liver has been demonstrated to help.

    You will be given medication to control pain when it becomes necessary. As your cancer progresses, you may be given strong opioids. Anti-nausea drugs are often given, either to treat nausea caused by the cancer or the side effects of chemotherapy. If the lungs are involved, you might be put on oxygen.

    Your doctor will also recommend treatments for your mental health, which might include meditation and therapy. Many patients and their families benefit from joining appropriate support groups. This is part of palliative care, which is not the same thing as hospice and does not always mean that there is no cure. Palliative care is about improving your quality of life, which might include helping you with diet and nutrition, the aforementioned mental health support, pain management, etc.

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    What Is The Difference Between Rectal Cancer And Other Cancers Affecting The Large Intestine

    There are different types of cancers and diseases that can affect the rectum. These include:

    • Colorectal cancer: This is a broad term describing cancers of the colon, rectum or both. Colorectal cancer is the third most common form of cancer in the U.S.
    • Hereditary non-polyposis colorectal cancer : This condition causes a mutation in an important gene one thats inherited or passed down from a parent to a child. About 5% of people with colorectal cancer have HNPCC.
    • Familial adenomatous polyposis : This rare hereditary condition causes multiple precancerous polyps to form in the large intestine. People with FAP usually develop polyps in their late teens or early 20s. The polyps become more problematic with age, increasing the risk for colorectal cancer.

    Standard Treatment Options For Stage I Colon Cancer

    Surgery

    Standard treatment options for stage I colon cancer include the following:

  • Wide surgical resection and anastomosis.
  • Evidence :

    The role of laparoscopic techniques in the treatment of colon cancer was examined in a multicenter, prospective, randomized trial comparing laparoscopic-assisted colectomy with open colectomy.

    • Three-year recurrence rates and 3-year overall survival rates were similar in the two groups.
    • The quality-of-life component of this trial has been published and minimal short-term quality-of-life benefits with LAC were reported.

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    End Of Life Management And Preparation

    Unfortunately, end-stage colon cancer is by definition terminal. Your doctor will discuss end-of-life care with you and your family early. You may already have had some of these conversations.

    Hospice care is generally the standard for end-of-life management with cancer, although at-home hospice care has become a more common option. Hospice care can start as early as six months before the projected end-of-life. Some people who go into hospice care rally and survive longer, so hospice is not necessarily an indicator that the end is imminent.

    However, there are certain signs that death is approaching. Progressive symptoms can include increasing lethargy, decreasing appetite, changes in mental state, and profound weakness.

    It should be noted that, not surprisingly, symptoms of decline can mimic that of depression a medical professional will regularly assess you and assist you along this journey. End-of-life care aims to improve symptoms, prevent suffering, and keep patients comfortable.

    Getting To And Staying At A Healthy Weight

    Patient Survived Stage 4 Colon Cancer, Twice

    Being overweight or obese is known to increase the risk of getting colorectal cancer. However, its not clear if having extra body weight raises the risk of colorectal cancer coming back or of dying from colorectal cancer. It’s also not clear if losing weight during or after treatment can actually lower the risk of colorectal cancer recurrence.

    Of course, getting to a healthy weight can have many other health benefits. But if youre thinking about losing weight, its important to discuss this with your doctor, especially if you’re still getting treatment or have just finished it.

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    Stage Information For Colon Cancer

    In This Section

    Treatment decisions can be made with reference to the TNM classification rather than to the older Dukes or the Modified Astler-Coller classification schema.

    The AJCC and a National Cancer Institutesponsored panel recommended that at least 12 lymph nodes be examined in patients with colon and rectal cancer to confirm the absence of nodal involvement by tumor. This recommendation takes into consideration that the number of lymph nodes examined is a reflection of the aggressiveness of lymphovascular mesenteric dissection at the time of surgical resection and the pathologic identification of nodes in the specimen. Retrospective studies demonstrated that the number of lymph nodes examined in colon and rectal surgery may be associated with patient outcome.

    How Long Will A Person With Stage 4 Colon Cancer Live

    Stage 4 colon cancer is known to be the most progressive stage or grade of this disorder. At this stage, this disease may also be referred to as metastatic colon cancer. However, first of all, you are required to understand what does stage 4 cancers mean and that not all of them are compulsorily alike. As per the general definition, a stage 4 colon or bowel cancer is that which has progressed or metastasized beyond the colon of the person. There are many various sites to which cancer can spread. Due to this reason, it is considered that all statistics pertaining to late-stage colon cancer survival are prone to be misleading. Each colon cancer is different. The body of every person as well as the general health and the medical conditions of the person has to be different. Therefore, the time period for which a person with colon cancer- stage 4 can live is also different from one individual to another.

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    How Fast Does Colon Cancer Spread

    Colorectal cancer tends to spread to the liver and lungs 2 years after initial cancer surgery.

    A looked at Swedish people with colorectal cancer. Of the people whose cancer had spread to the liver, the researchers found that:

    • 76 percent were diagnosed with liver metastases within 1 year of their colorectal cancer diagnosis
    • 89 percent were diagnosed with liver metastases within 2 years
    • 93 percent were diagnosed with liver metastases within 3 years

    How the cancer spreads will depend on factors like:

    • how early the cancer is found
    • how it was treated
    • the biology of the cancer
    • the aggressiveness of the cell type
    • whether theres a genetic component
    • whether theres a family history of the cancer

    Permission To Use This Summary

    Adenocarcinoma Stomach Life Expectancy

    PDQ is a registered trademark. Although the content of PDQ documents can be used freely as text, it cannot be identified as an NCI PDQ cancer information summary unless it is presented in its entirety and is regularly updated. However, an author would be permitted to write a sentence such as NCIs PDQ cancer information summary about breast cancer prevention states the risks succinctly: .

    The preferred citation for this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Colon Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .

    Images in this summary are used with permission of the author, artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner and cannot be granted by the National Cancer Institute. Information about using the illustrations in this summary, along with many other cancer-related images, is available in Visuals Online, a collection of over 2,000 scientific images.

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