Colorectal cancer is the third leading cause of cancer and the second leading cause of all cancer-related deaths in the United States. Each year approximately 145,000 new cases of colorectal cancer are diagnosed in the United States (105,000 new cases of colon cancer and 40,000 new cases of rectal cancer). The lifetime chances of developing colorectal cancer is approximately 5%. Combined, these two types of cancer cause 56,000 deaths per year. The frequency of colon cancer is essentially the same among men and women. Signs and symptoms associated with colorectal cancer include:
- Rectal bleeding (overt or occult)
- Change in bowel habits
- Mucus per rectum
- Abdominal pain
- Weight loss
If detected early, colon and rectal cancer are curable by surgery. Long-term survival correlates with the stage at diagnosis of the disease in colorectal cancer. Progress has been made in understanding the basis for predisposition and progression of colorectal cancer. Risk factors for colorectal cancer include:
- Age
- Diet rich in fat and cholesterol
- Inflammatory bowel disease (ulcerative colitis)
- Alcohol ingestion in rectal cancer
- Genetic predisposition (hereditary polyposis and nonpolyposis syndromes)
Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common known hereditary cause of colon cancer. HNPCC is hereditary and involves a mutation in one of five different genes and is also known as Lynch Syndrome. About 1% to 5% of colon cancers are attributed to HNPCC. A patient with HNPCC has up to 80% chance of developing colon cancer during their lifetime. The mean age for someone with HNPCC developing colorectal cancer is 44 years. Cancers tend to be on the right (ascending) colon, are poorly differentiated and mucus producing. Genetic testing and screening in these individuals with HNPCC for colon cancer should be started as early as 20-22 years of age.
The vast majority of colorectal cancers are adenocarcinomas which arise from a preexisting adenomatous polyp(s) that develop in the normal colon mucosa. The progression sequence from adenoma to carcinoma is a well characterized clinical and histopathological series of events. Convincing evidence of increased early detection resulting in a reduced colorectal cancer mortality supports the use of specific screening guidelines which include:
- Colonoscopy
- Flexible sigmoidoscopy
- Barium enema
- Fecal occult blood test
- Carcinoembryonic antigen (CEA)
- Digital rectal examination
- Stage A: Carcinoma confined to the wall of the bowel
- Stage B: Carcinoma spread by direct continuity to perirectal or pericolonic tissue; no lymph node metastasis
- Stage C: Metastasis present in regional lymph nodes
- Stage D: Omental implant; peritoneal seeding; metastasis beyond the confines of surgical resection
- TNM 0: Tis, N0, M0
- TNM I: T1, N0, M0 & T2, N0, M0
- TNM II: T3, N0, M0 & T4, N0, M0
- TNM III: Any T, N1, M0 & Any T, N2, M0
- TNM IV: Any T, Any N, M1
Failure to adhere to the acceptable screening guidelines can result in a significant delay in the diagnosis of colon and rectal cancer, depriving a patient of a meaningful chance of cure and a better quality of life.
The overall 5 year survival rate from colon cancer is approximately 60%. the 5 year survival rate is different for each stage of the disease at the time of diagnosis. Several classifications are utilized to stage colon cancer. The Dukes and TNM System are the most widely used.
Dukes (modified) Classification
Tumor-Node-Metastasis (TNM) System
For Dukes stage A tumors involving only the mucosa, the 5 year survival rate exceeds 90%; For Dukes stage B colon cancers, the 5 year survival rate is greater than 70% and can get to be better than 80% if the tumor does not penetrate the muscularis mucosa; For Dukes stage C with lymph nodes involvement, the 5 year survival rate is usually less than 60%; and for metastatic colon cancer, the 5 year survival rate is about 5%.
If you (or a loved one) are suffering from complications due to a failure to timely diagnose, delayed diagnosis or misdiagnosis of colon or rectal cancer, or the recommended screening guidelines were not followed, let the Boston area medical malpractice attorneys at Barry D. Lang, M.D. & Associates evaluate your case. We can help you assert your rights and get the compensation you deserve.
Contact Information
If you, your child or a member of your family have been injured as a result of a postoperative complication, substandard postoperative care, deficient medical treatment or failure to be properly treated, please let our Boston area medical malpractice attorneys at Barry D. Lang, M.D. & Associates evaluate your case. For a free confidential consultation and receive a response within 24 hours (when possible), please contact us by phone, fax or e-mail with your question or concern.
Telephone: 617-720-0176
Fax: 617-720-1184
