Detection and stage of colorectal cancer (colon and rectum)

Colorectal cancer (cancer of the colon / colon and / or rectum) is included in the list of types of cancer causing the world's largest death, according to WHO in 2018. The high mortality rate is most likely caused by the late detection of colon and rectal cancer so that it is only known when the cancer enters. advanced stage. So, what are the tests to diagnose colorectal cancer? Then, can stage 4 colon and rectal cancer be cured?

The importance of early detection of colon and rectal cancer

About 36.1% of colon and rectal cancer patients who come to the hospital have entered stage IV. Meanwhile, only about 3.4% of the patients who came with the condition were still in stage 0-1.

Whereas early detection is the key in reducing colorectal cancer cases, according to dr. Abdul Hamid Rochanan, Sp.B-KBD, M.Kes, Secretary General of the Association of Indonesian Digestive Surgeons (IKABDI) when met at a media discussion initiated by the Cancer Information & Support Center (CISC).

The same thing was also conveyed by dr. Ronald A. Hukom, MHSc, SpPD-KHOM, internist and medical oncologist at Dharmais Cancer Hospital, Jakarta.

"Colorectal cancer (colon / colon and rectum) is a disease that you detect early through a stool test. Therefore, wajin gets checked out if you are at high risk, ”explained dr. Ronald when met at the same opportunity.

Early detection of colon and rectal cancer, increases the percentage of patients to recover from this disease. The reason is because the cancer has not spread and damaged the surrounding healthy tissues and organs, making it easier for treatment to remove and kill cancer cells.

Tests for detection and diagnosis of colon and rectal cancer

In order to detect, make a diagnosis, know the stage and possibly the cause of colorectal cancer, your doctor will ask you to do some medical tests. Reporting from the American Cancer Society website, medical tests for the diagnosis of colon and rectal cancer, include:

1. Physical exam and medical history

In this test, the doctor will ask you what symptoms of colon and rectal cancer you may be experiencing and for how long they have been felt. The test will be followed by checking for swelling in the stomach or plug the anus, where the doctor inserts a finger into the rectum to feel for any abnormal tissue growth.

Then, the doctor will also look for possible risk factors, including the medical history of family members.

2. Stool test

The next colon and rectal cancer detection and diagnosis test is a stool test. In this test, the doctor will check for blood that is not visible to the naked eye (occult). You will be asked to collect 1-3 stool samples each day.

3. Blood test

Cancer patients who attack the digestive system are prone to anemia (lack of red blood cells). So, in this test the doctor will measure the levels of red blood cells. In addition, blood tests are also performed to see liver function because colorectal cancer can spread to these organs.

Finally, a blood test can show markers of colorectal cancer cells, namely high levels of carcinoembryonic antigen (CEA) and CA 19-9 in the blood.

4. Colonoscopy and proctoscopy

Colonoscopy is a cancer detection test by looking at the condition of the colon and rectum using a colonoscope equipped with a recording camera at the end.

If the doctor suspects cancer is in the rectum, the doctor will recommend a proctoscopy test, which is inserting a protoscope through the anus. Through this test the doctor can determine the location of the cancer and its size.

5. Biopsy

When a colonoscopy is performed and the doctor finds suspicious tissue, the doctor will perform a biopsy. A biopsy is a test for diagnosing cancer by taking tissue as a sample to be examined more deeply in the laboratory.

6. Imaging tests

Colon (colon) and rectal cancer detection tests are further imaging tests, including CT scans, abdominal ultrasound, chest x-rays, endorectal ultrasound (the transducer is inserted into the rectum), and intraoperative ultrasound (the transducer is placed over the surface of the liver).

The purpose of this test is to look at the condition of the colon, rectum, and find out to what extent cancer cells have spread.

Know the stage of colorectal cancer (colon / rectum)

Taking the medical tests above makes it easier for doctors to determine the stage of colorectal cancer. In this case, there are several terms used, namely T (tumor), N (lymph nodes), and M (metastatic / spread of cancer).

More specifically, consider some examples of terms used in determining the diagnosis of colorectal cancer:

• Colorectal cancer stage 1 T1 / T2 N0 M0: cancer growing through the muscularis mucosa into the submucosa (T1), or growing into the muscularis propia (T2), has not spread to lymph nodes (N0) or other areas (M0).
• Colorectal cancer stage 2A T3 N0 M0: cancer has grown to the outermost layer of the colon, but has not penetrated the rectum (T3), has not spread to lymph nodes (N0), or other areas (M0).
• Colorectal cancer stage 3B T1 / T2 N2b M0: cancer has grown from the mucosa to the submucosa (T1) or grows in the muscularis propia (T2), has spread to 7 or more lymph nodes (N2b), but not yet to other distant areas (M0).
• Stage 4 colorectal cancer any T any N M1a: Cancer does not grow on the walls of the colon or rectum (any T), does not spread to lymph nodes (any N), but spreads to the liver, lungs, or distant lymph nodes (M1a).

Can stage 4 colorectal (colon / rectum) cancer be cured?

Colon (colon) and rectal cancer stages 1,2, and 3 that are not yet severe can be cured with treatment. However, some advanced stage 3 colon (colon) cancers and stage 4 can not be cured.

Even so, patients still need to undergo colorectal cancer treatment. The goal is to relieve symptoms, slow the spread of cancer cells, and of course make the patient's quality of life better.