Colon cancer is one of the most preventable cancers and, if caught early, is extremely treatable and even curative in many cases. Early detection is often in the hands of patients, which is why scheduling your colonoscopies on time is important. If you want to know more about how colon cancer is most commonly detected and what your treatment options are, read on.
How Is colon cancer detected?
Dr. Ohmar Coughlin at The Iowa Clinic emphasizes that patients are often in the driver’s seat for how quickly potentially cancerous polyps can be detected and removed. Recently, the guidelines for colonoscopies changed, lowering the starting age for screening to 45 for patients with average risk. Patients with higher risk (a family history of colon cancer or precancerous polyps) should work with their primary care team to determine the best starting time and cadence for regular screenings.
“In many patients, colon cancer is first discovered in a colonoscopy,” Dr. Coughlin says, “That’s one of the challenges, because it is often an asymptomatic cancer. The patient may have no idea that it’s there. This is why we continually emphasize the importance of scheduling those routine colonoscopies.”
Not all instances of colon cancer are asymptomatic, though. Sometimes, colon cancer presents with symptoms like bowel blockages and blood in the stool and is identified from there.
“Once the tumor is identified and marked, most patients are referred to surgery for treatment. Surgery is very effective for colon cancer, but if the cancer has metastasized outside of the colon, treatment looks different. Early screening is so important in the detection process,” Dr. Coughlin says.
How is colon cancer treated?
The approach to colon cancer treatment depends heavily on whether the cancer itself is contained within the colon. Let’s break it down.
Treatment for Cancers Contained Within the Colon
For cancers contained within the colon, treatment is almost always surgical. In many cases, the surgical treatment is curative. However, curative surgical treatment doesn’t mean that recurrences are completely out of the question.
“In the category of early stage cancer where surgery has cured, we do work closely with that patient’s GI or endoscopist to ensure they have colonoscopies at the appropriate intervals (early and frequent). Once a patient has a history of colon cancer, they are considered high risk for repeat cancers. They’ll have colonoscopies more frequently than patients with an average risk,” Dr. Coughlin says.
When patients schedule surgery for their cancer, Dr. Coughlin notes that all concerns are discussed and addressed during the initial consultation. A need for a colostomy bag is one of the most common fears patients have, but Dr. Coughlin says that it is very rarely needed.
“Our goals are the same as the patients’, we don’t use an ostomy unless it’s absolutely necessary,” Dr. Coughlin says. “In most patients, we are able to reconnect which eliminates the need for an ostomy bag. We always discuss with patients when one would be necessary, but we also discuss all the efforts we take to avoid these instances.”
Treatment for Colon Cancers that Have Metastasized
For patients with more advanced colon cancers that have spread outside of the colon, the treatment process often looks different. Because the cancer has moved outside of the colon, surgical intervention is less likely to be curative. However, surgery will often have a role. “For patients with more advanced stage colon cancer, we work closely with our medical oncology department who provide recommendations for chemotherapy and coordinate CT scans and lab work in the future so we can quickly identify recurrence,” Dr. Coughlin says.
Follow up after colon cancer treatment
Post-surgical care is as important to the recovery process as the surgery itself. Thanks to advancements in surgical technology, the recovery period is much better than it used to be, and patients can often be back to normal life within a few months.
Most patients are admitted after the minimally invasive surgery for 2-7 days while they recover before being discharged.
“With small incisions we work to have patients active and moving on the day of the surgery. We encourage people to get back to their normal routine after surgery as quickly as we can. The caveat is they can’t lift more than 10 pounds or overexert themselves for the first two months,” Dr. Coughlin says.
After that, follow-up often happens 2-4 weeks post-surgery so the care team can ensure recovery is going well and there have been no complications.
“Pain after surgery is a concern many patients have,” Dr. Coughlin says, “So we work to address that with multimodal pain relief, avoiding narcotics whenever possible. The way we place the incisions, the method of surgery, everything we do is done with minimizing pain in mind.”
Long-term, patients who have had colon cancer will require more frequent colonoscopy screening as they are more likely to develop polyps again in the future.
How The Iowa Clinic handles colon cancer treatment
While facing the “Big C” in any form can be an extremely scary time, the professionals at The Iowa Clinic work together to make your treatment process as comfortable and reassuring as possible. With a Coordinated Care approach, your care team will work across departments to ensure you are cared for in every aspect of your health.
“We have a team of fellowship trained colorectal surgeons who specialize in this disease process. We work closely together with each other, with PCPs, and with the extended care team (gastroenterology, radiology, medical oncology) to provide an efficient and high-quality care experience,” Dr. Coughlin says. “We provide this with collaboration and a clear treatment pathway for the patient and their families.”
If you are concerned about your colorectal health, discuss colonoscopies with your primary care provider today, or make an appointment with a specialist.
OhmarCoughlin , MD, FACS, FASCRS
Ohmar Coughlin, MD joined The Iowa Clinic for the positive culture that provides compassion, professionalism, and collaboration among physicians.
Dr. Coughlin finds Colorectal Surgery rewarding when he is involved in making a difference in the lives of his patients who have a rare disease or a frightening diagnosis. With each patient, he strives for understanding and a specialized treatment plan. Also, he believes being empowered to manage your own care provides the best outcomes.
Outside of work, Dr. Coughlin enjoys spending time walking, biking, and hiking with his wife and three children.