Colon cancer expert Mark Kozloff, MD, explains how cancer treatment decisions are made based on the clinical stage and modern testing practices.
Mark F. Kozloff, MD: Once the diagnosis of colon cancer is made, one does clinical staging and what should do besides the colonoscopy, you have the CAT scan with physical exam, blood test, and then, once one knows what the clinical stage is, a treatment decision is made. If a person is stage 1, 2, or 3 meaning that the cancer is confined to the colon or confined to the colon in nearby lymph nodes, the primary treatment is that of surgery and than one may add on afterwards that of chemotherapy depending upon what the pathological stage is.
That’s the findings at the time surgery in which that if one is stage 1, all that is needed is a surgery, if a person is stage 3, then one gets the surgery and offers what we call adjuvant chemotherapy. Chemotherapy in addition to surgery to increase the chances of cure by going after disease that one cannot see.
For person who is stage 2, sometimes people offer chemotherapy as an adjuvant, sometimes not and there is a situation where Oncotype DX maybe helpful in delineating the exact prognosis in stage 2 to help the side on adjuvant therapy.
If a person is stage 4 at the time of diagnosis, meaning the CAT scan has shown spread to the liver or the lung, the primary treatment is that of chemotherapy and not surgery and surgery or radiation can be used to treat localize symptomatic problems, but again you want to have a treatment that goes through the blood stream and goes to the cancer wherever it is. So the treatment will change depending upon both the clinical as well as the pathological stage of the illness.
Mark F. Kozloff, MD, has more than 30 years of experience treating many types of adult cancers. He works on a multidisciplinary team of experts in the Center for Gastrointestinal Oncology where he specializes in the treatment of colorectal malignancies.
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