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Colorectoral Cancer: Diagnosis and Staging

A patient with colon, rectal or colorectoral cancer symptoms may have one or more of the following procedures to diagnose colorectoral cancer and/or other gastrointestinal cancers:

  • Flexible Sigmoidoscopy: This test uses a flexible, lighted tube about the thickness of a finger with a small video camera on the end. It is inserted through the rectum and into the lower part of the colon. Images from the scope are viewed on a display monitor. The doctor is able to see the entire rectum but less than half of the colon with this procedure.
     
  • Colonoscopy: This test allows the doctor to look at the entire length of the colon and rectum with a colonoscope, which is a longer version of a sigmoidoscope. It is inserted through the rectum into the colon. The colonoscope has a video camera on the end connected to a display monitor. Special instruments can be passed through the colonoscope to remove any suspicious looking areas such as polyps. Patients are sedated for this test.
     
  • Double Contrast Barium Enema: This procedure is also called an air-contrast barium enema or a barium enema with air contrast. It is basically a type of x-ray test. Barium sulfate, which is a chalky liquid, and air are used to outline the inner part of the colon and rectum, which highlights abnormal areas on x-rays. Suspicious areas require a colonoscopy to explore them further.
     
  • CT Colonography (Virtual Colonoscopy): This is an advanced type of computed tomography (CT or CAT) scan of the colon and rectum. A CT scanner takes many x-ray pictures as it rotates around you while you lie on a table. A computer then combines these pictures into images of slices of the part of your body being studied.

    This test is non-invasive, can be done fairly quickly, and does not require sedation. If polyps or other suspicious areas are seen, a colonoscopy will likely be needed to remove them or to explore them fully.

Signs and Symptoms of Colon Cancer and Early Stage Colorectoral Cancer

There are usually no symptoms associated with early-stage colorectal cancer.

The American Cancer Society lists the following symptoms associated with more advanced stages of colorectal cancer:

  • Rectal bleeding
  • Blood in the stool
  • Change in bowel habits
  • Cramping pain in the lower abdomen

Although these symptoms may be caused by factors unrelated to colorectal cancer, it is important to seek medical attention to rule out cancer.

Staging for Colorectoral Cancer

  • Stage 0: The colon, rectal or colorectoral cancer is in the earliest stage. It has not grown beyond the inner layer (mucosa) of the colon or rectum. This stage is also known as carcinoma in situ or intramucosal carcinoma.
     
  • Stage I: The cancer has grown through the muscularis mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has not spread to nearby lymph nodes or distant sites.
     
  • Stage IIA: The cancer has grown into the outermost layers of the colon or rectum but has not reached nearby organs. It has not yet spread to the nearby lymph nodes or distant sites.
     
  • Stage IIB: The cancer has grown through the wall of the colon or rectum and into other nearby tissues or organs. It has not yet spread to the nearby lymph nodes or distant sites.
     
  • Stage IIIA: The cancer has grown through the mucosa into the submucosa (T1) or it may also have grown into the muscularis propria (T2). It has spread to 1 to 3 nearby lymph nodes but not to distant sites.
     
  • Stage IIIB: The cancer has grown into the outermost layers of the colon or rectum but has not reached nearby organs (T3) or the cancer has grown through the wall of the colon or rectum and into other nearby tissues or organs (T4). It has spread to 1 to 3 nearby lymph nodes but not distant sites.
     
  • Stage IIIC: The cancer may or may not have grown through the wall of the colon or rectum, but it has spread to four or more nearby lymph nodes. It has not spread to distant sites.
     
  • Stage IV: The cancer may or may not have grown through the wall of the colon or rectum, and it may or may not have spread to nearby lymph nodes. It has spread to distant sites such as the liver, lung, peritoneum (the membrane lining the abdominal cavity), or ovary.
     

Colorectoral Symptoms, Diagnosis and Staging Questions and Appointments

Contact us for more information about our colorectoral cancer treatment programs.