NCCN Guidelines for Patients
Colon Cancer, Version 1.2017
Sessile polyps have worse outcomes than other
polyps when surgery isn’t received.
Either type of polyp may have high-risk features.
In this case, surgery is advised. The part of the
colon with cancer and some lymph nodes should be
lists the treatment options for tumors rated
as T2. These tumors haven’t grown beyond the third
layer of the colon wall. Treatment is needed.
If you are able to have surgery, a colectomy and
lymphadenectomy are advised. It is very rare that
surgery can’t be done. In this case, sometimes
chemotherapy is given if you’re healthy enough.
Radiation therapy may be added.
In very rare cases, a T2 tumor has grown so large
that it blocks the flow of stool. There are four options
when there is a blockage. One option is a colectomy
that unblocks your gut. Another option is removal
of the cancer and a diversion within one operation.
A diversion is a surgery that attaches the colon to
the surface of the abdomen, and a “bag” is needed.
A third option is a diversion followed by a second
operation to remove the cancer. Last, some people
can get a stent followed by a second operation to
remove the cancer.
The tissue that is removed from your body will be
sent to a pathologist. The pathologist will assess how
far the cancer has grown within the colon wall. He or
she will also test for cancer in your lymph nodes. If
the cancer stage doesn’t change, you will not need
more treatment. If the cancer is upstaged to stage
II or III, read
. This guide lists what further
treatment is advised.
lists follow-up testing for polyps with
cancer. Follow-up testing is started when there are
no signs of cancer after treatment. It can be helpful
for finding new cancer growth early.
A colonoscopy is recommended 1 year after
treatment has ended. If results are normal, the next
colonoscopy should be received in 3 years and then
every 5 years. If an advanced adenoma is found,
your next colonoscopy will be needed within 1 year.
Advanced adenomas include polyps with a ruffled
structure (villous), a polyp larger than the width of an
AAA battery (>1 cm), or a polyp with pre-cancerous
cells (high-grade dysplasia).