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Ask The Expert Archive

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Colon Cancer Archive Questions

Below are Dr. Hanna’s answers to Colon Cancer questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Questions about this topic have been organized into several categories.
Click on a category name below or select "View All" to read all the Q&As in this archive.

. Diagnosis
. General information
. Screening
. Treatment
. View all Questions
. All Questions

Now displaying records 1 to 15 of 58.

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Q : 1

My father was recently diagnosed with low-lying, stage IIA rectal cancer (T3N0M0). His pre-chemo CEA level was 19.2 ng/ml. What might this number tell us about his response to chemo and chemoradiation treatment?

It is of a prognostic value. It would be expected that this number drop with treatment.

Q : 2

Is taking biopsies on the first colonoscopy after surgery to remove a tumor a regular process?

Taking biopsies is routine if some abnormalities are seen during the endoscopy. This does not necessary mean disease recurrence, unless biopsy is positive.

Q : 3

Two weeks ago, I was diagnosed with colon adenocarcinoma and during the colonscopy, my doctor said that I needed surgery to remove the cancerous portion. Is this the only option?

If you have colon cancer, you will need surgery to resect that portion of the colon.

Q : 4

I was diagnosed with stage 3 rectal cancer in January of 2010. This soon progressed to stage 4 as two small liver tumors were discovered. Both the liver and rectal tumors were resected with clean margins and just one cancerous node in May and July of 2010. By May of 2011, I had two small tumors in my peritoneum, as well as a small tumor in my lung and one in my chest wall. These were biopsied as colorectal cancer metastases. I considered HIPEC but was told by the surgeon that I was not a good candidate due to the non-peritoneal metastases. So I went on Folfiri + Avastin and am slowly having progression. My question is do you agree that I'm not a good candidate for HIPEC? Secondly, assuming I continue on my current course, how much longer before I get a bowel obstruction? I can feel several tumors in my abdomen, but the PET-CT only detects two.

Data suggest that liver lesions that can be treated should not exclude patient from having the HIPEC procedure. You should be re-evaluated. Will be happy to review you case. Nader Hanna, MD 410-328-7320

Q : 5

A year ago, I had a 2cm colon polyp removed that didn't penetrate the colon wall tissue. I have been taking curcumin and pepper and I feel great. My surgeon said this is non-conventional treatment and I should have a bowel resection even though there is no guarantee of a cure. What are your thoughts?

The indication of surgery is based on depth of the tumor invasion into polyp. If a colectomy is indicated, it provides the best chance for a cure and should be considered.

Q : 6

What are the newest treatment options for metastatic colon cancer (to liver, lungs, bone)? Where are the best oncology clinics?

The newest treatment for metastatic colon cancer is systemic chemotherapy along with a biological agent. NCI-designated centers, like ours, are the best places to go for the treatment of cancer.

Q : 7

I recently had a colonoscopy and it was noted that I had lymphoid hyperplasia. Is this a precursor to cancer? Is it something to be worried about?

No, this is not cancerous so you don't need to be worried.

Q : 8

My husband has a 45 mm flat polyp in his ascending colon. We met with a surgeon today who is recommending removal of his right colon and surrounding lymph nodes. Are there other options that are less intrusive?

With a polyp that size, it is best to have the surgery. The risk of cancer in the polyp is high enough that surgery is also preferable especially if there is high grade dysplasia.

Q : 9

My husband had a sigmoid colon resection. He was staged at T3N0M0. Does this mean that he is cancer free?

This is a stage II colon cancer where surgery is an adequate treatment with no need for chemotherapy (provided there were 12 nodes in the specimen). He will need surveillance for identification of any early recurrence or new tumor.

Q : 10

I had my anus removed during colon cancer surgery. Can my anus be replaced so that I don't have to use a colostomy?

No, that procedure is irreversible and colostomy is the only option.

Q : 11

I am experiencing tenesmus following treatment for colon cancer. Why is this?

If you received radiation therapy, your pain is likely caused by radiation colitis.

Q : 12

I have had 6 polyps(benign) removed from my large intestine. I still have many small ones that my doctor is worried about. He said that he is contemplating total removal of the large bowel. What do you suggest?

That seems very radical and I am not sure I would agree with that recommendation. I would suggest getting a second opinion.

Q : 13

Would you recommend for a patient to receive chemotherapy prior to surgery for a "poorly differentiated adenocarcinoma with extensive necrosis" in the ascending colon?

This would not be considered the standard of care unless the cancer was metastatic.

Q : 14

Do tubular, tubulovillous, and vellosos polyps carry different risks for developing cancer?

Yes. Villous adenomas have the highest risk of becoming cancerous and tubular adenomas have the lowest risk.

Q : 15

My husband developed a fistula after having a resection of the large bowel. The fistula is connected from the anastomosis to the surface of the skin. He currently has an ileostomy which is functioning quite well. No stoma was formed during the surgery but the fistula has been draining continuously over the last eight months. What can be done?

If it has been eight months and it hasn't healed by now, then surgery is the best option.

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