Treatment for colon cancer starts with a thorough discussion of your options, according to oncologist Daniel Labow, of The Mount Sinai Medical Center, in this WisePatient video.
Two tests are used to diagnose colon cancer: a rectal exam or a colonoscopy. In this video, Daniel Labow, MD, an oncology surgeon at The Mount Sinai Medical Center, explains what is involved with both medical tests.
In sigmoidoscopy, an endoscope (a flexible tube) is used to view the rectum and lower part of the large intestine. The effectiveness of this method as a screening test for colorectal cancer depends on the type of instrument used. The shortest, the rigid sigmoidoscope, is too short to detect colorectal cancers, which usually occur outside its reach. It is no longer recommended for use in colon cancer screening. The two other types, the short flexible fiberoptic sigmoidoscope and the long flexible fiberoptic sigmoidoscope, are longer and therefore more effective.
Although a gloved-finger examination of the rectum is sometimes successful in finding tissue growths, a digital rectal examination is not the most effective way to screen for colorectal cancer. Because most cancers occur outside the limited access of this procedure, a negative test result would not rule out colorectal cancer. Most polyps are found during sigmoidoscopy. This examination is no longer recommended as a general screening test.
The results of the medical history and physical exam may mean that a person needs to begin routine testing for colorectal cancer earlier than age 50 and have it more often. Your doctor may recommend earlier or more frequent testing if you:
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You can help your doctor diagnose and treat your condition by being ready to answer the following questions:
During a physical exam, your doctor will:
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It is always a good idea to obtain a second opinion, especially if you are diagnosed with a serious illness, but the good news is that colon and rectal cancers are curable when detected early.
Colonoscopy has long been the gold standard for catching colorectal cancer, but it is not the only screening test. Men and women should have some type of screening generally starting at age 50: yearly testing to check for blood in the stool, a flexible sigmoidoscopy every five years, or a colonoscopy every 10 years.
Fecal occult blood tests analyze stool samples for blood, which may signal polyps or cancer. They involve placing small amounts of stool on special cards that are examined under a microscope.
Flexible sigmoidoscopy is a procedure in which a physician looks at the lower third of the colon and surrounding areas with a small, tube-like camera. Performed in a doctor’s office with minimal sedation, sigmoidoscopy will detect most, but not all colon cancers.
Colonoscopy is the best way to visualize the entire colon. It involves threading a luminous tube into and around the colon to detect abnormalities.
Virtual colonoscopy is a less invasive alternative to the standard procedure. It uses a CT scan to produce pictures of the colon for analysis. Data on the accuracy of virtual versus normal colonoscopies have been mixed -- and, as with sigmoidoscopy, any irregularities mean you’ll also have to undergo a full colonoscopy.