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Your doctor will first review your medical history. A complete medical exam will be done. One or more of the following tests may be done:
Digital Rectal Exam—Your doctor will insert a lubricated gloved finger into the rectum. The doctor will check the rectum for lumps or abnormal areas. About half of colon cancers can be detected in this way, especially if a test for occult blood is done at the same time. It is not a good idea to ask your doctor to skip your rectal exam during a routine checkup. It is a good idea to agree to having your stool tested for occult blood.
X-ray of the Large Intestine—An x-ray will provide a picture to help identify the presence of polyps. This is often done with the addition of contrast medium (barium). Barium will help to create better pictures of the surface of the bowel.
Fecal Occult Blood Test—A small sample of stool is placed on a special card. It is then tested by a lab for hidden blood. Blood can be present in the stool for many reasons. Colorectal cancer will not always cause blood in the stool. If positive, the test should be followed up with a more specific test such as endoscopy. A negative result does not guarantee that colorectal cancer is not present.
Endocsopy—In endocscopy, the doctor inserts a flexible tube into the bowel. The tube contains a camera that is used to examine the interior surface of the bowel. The doctor will look for irregularities, such as polyps. Two types of endoscopy include:
Polypectomy—The removal of a polyp or polyps during sigmoidoscopy or colonoscopy.
Biopsy —A tissue sample from a polyp is removed from the body. It is sent to a pathologist for examination.
Barium Enema —A barium liquid is put into the rectum by way of the anus. Barium is a metallic compound that helps highlight the image of the lower gastrointestinal tract on an x-ray.
Virtual Colonscopy—A type of CT scan that uses computer software along with CT imaging to examine to colon for polyps. A rubber catheter is used to introduce air into the colon. This procedure is still being studied. Some of the benefits of a virtual colonoscopy include:
Some studies indicate that virtual colonscopy is almost as effective as endoscopy for determining the presence of polyps. However, if a polyp is found by virtual colonoscopy, a second procedure is necessary to remove and examine it. Virtual colonoscopy is not appropriate if you have a higher risk for developing polyps. With conventional endoscopy, the biopsy can usually be done at the same time. Virtual colonscopy is not available everywhere.
Staging
Staging is a careful attempt to determine whether the cancer has spread from the inner lining of the colon. If the cancer has spread, staging will also help determine what body parts are affected.
If cancer is found, the prognosis and treatment depend on the location, size, and stage of the cancer and your general health.
Additional tests to determine the cancer’s stage may include:
If colorectal cancer is diagnosed, the following staging classification is used to identify how and where the cancer has spread.
References:
National Cancer Institute website. Available at: http://www.cancer.gov/ .
Last reviewed February 2009 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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