Word: colon
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Dates: during 1990-1999
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That uncertainty may be getting cleared up. Last week a panel of experts from the American Society of Clinical Oncology published the first scientifically based guidelines for monitoring the return of colon cancer. The report, which is based on a review of 20 years of data, is bound to stir up controversy, however, because it suggests a minimalist approach for patients with no new symptoms. Doctors must always ask themselves whether a given test will do their patients any good, says Dr. Al Benson, the panel's co-chair and a medical oncologist at Northwestern University in Chicago. After...
First, a note of caution. The new guidelines are a work in progress and should not supersede your doctor's best judgment. Nor do they apply if you are participating in a clinical trial or have been diagnosed with hereditary colon cancer...
...some background. Colon cancer is highly curable when caught in the earliest stages. However, most relapses, when they occur, show up within five years of the initial treatment and are usually fatal. Perhaps 5% of metastasizing tumors are small enough to give patients a reasonable chance for complete cure. So there's a premium on finding and treating them early...
...colleagues concluded that patients should undergo a colonoscopy three years after the one that was done at the time of surgery, provided that all cancers and polyps were removed. Why not sooner? Repeat colonoscopies are most useful for finding a new tumor unrelated to the old one. Most recurring colon cancers form elsewhere in the body, and most new cancers take time to grow...
...other tests received qualified endorsements. The CEA test, which detects as many as 80% of colon-cancer recurrences, measures the amount of carcinoembryonic antigen, a protein found in the blood that is often produced by tumor cells. Regular proctosigmoidoscopy, which looks directly at the rectum, is recommended for patients with rectal cancer who have not undergone standard treatment with radiation...