- What type of colon cancer do I have?
More than likely, the type of colorectal cancer you have is adenocarcinoma, which accounts for approximately 90-95% of all colorectal cancers. There are, however, subtypes of adenocarcinoma (such as signet ring cell and mucinous) and a variety of non-adenocarcinoma colorectal cancers as well, such as neuroendocrine tumors, lymphoma, leiomyosarcoma, and melanoma. The type of colorectal cancer you have can significantly influence your treatment options and prognosis.
- What stage is my cancer?
Determining the colorectal cancer stage is an important part of choosing an appropriate treatment. Colorectal cancer used to be rated using the Duke’s system. For example, Duke’s A cancer was the equivalent of stage 1 cancer. Your doctor will be able to explain in detail which stage your cancer is in and exactly what that means. If you have stage 2 colorectal cancer, be sure to ask whether it is stage 2a or 2b; if you have stage 3, be certain to ask whether it is stage 3a, 3b, or 3c. They each represent something different and can impact the treatment plan.
- What are my treatment options?
Colorectal cancer surgery is the most common treatment for colorectal cancer. In ideal situations, where the cancer is found at a very early stage, a doctor can remove the tumor with a colonoscope during a colonoscopy. Most of the time, however, colorectal surgery is required. Chemotherapy is sometimes recommended for stage 2 colorectal cancer, and usually recommended for stage 3 and stage 4 colorectal cancer in combination with biological therapies that specifically target cancer cells. Radiation therapy is also used in the treatment of colorectal cancer. For a more thorough review of colorectal cancer therapies, please visit the Colorectal Cancer Association of Canada’s website under the headings: “Just the Facts” (www.colorectal-cancer.ca/en/just-the-facts/what-cancer/) and “Treatments” (www.colorectal-cancer.ca/en/treating-cancer/treatment-cancer/).
- What is my prognosis?
Many patients wish to know what their prognosis is but many physicians feel uncomfortable about providing an estimate, especially with later-stage cancers. Please know that your prognosis may change depending upon the different treatment options accessed and nothing is truly written in stone.
- What doctors do you recommend?
Finding the right doctor is an important part of your care. The doctor who diagnosed you (such as the gastroenterologist) may be able to offer recommendations based on his/her personal experience with certain doctors. Remember that it is the patient who makes the final decisions. It is the patient who decides which treatment options to pursue and who is a member of their treatment team. Recommendations would include the following:
- A gastroenterologist or medical oncologist to provide a second opinion
- A medical oncologist to help you settle on a course of treatment
- A colon surgeon to remove the tumor (surgical oncologist)
- Surgeons who specialize in other organs if the cancer has spread to the liver, lungs, brain or peritoneum (surgical oncologists)