Colon Cancer Treatment: Making the Right Choices

Summary & Participants

Being diagnosed with colon cancer is hard news to receive. Deciding how to treat it can be even more challenging. Do you know all your choices? How do you know which is best for you? Who will help you make the right treatment decisions? Join our panel as they discuss the available options--from diagnosis to treatment--and walk you through some possible scenarios.

Medically Reviewed On: June 19, 2008

Webcast Transcript

DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. It's not easy to have someone tell you that you have colon cancer. But the treatment decisions that follow can be even more challenging. How do you and your doctor decide which treatment is best? How do you weigh the possible benefits against the potential risks? It's always a personal journey. But, here to discuss some of the common issues are three experts. First is Dr. John Macdonald. He's an oncologist at St. Vincent's Comprehensive Cancer Center.

Next to him is Dr. Michael Lieberman, a colorectal surgeon at the Weill Cornell Medical College. Thanks for being here.

And on his left is Dr. Mark Pochapin. He is a gastroenterologist at the Weill Cornell Medical College. Thanks for being here.

Who is involved in these treatment decisions from the get-go?

JOHN MacDONALD, MD: Basically the people making the diagnosis of colon cancer tend to be gastroenterologists or surgical oncologists. Medical oncologists rarely make the primary diagnosis. It's really primarily the gastroenterologist and surgeon who are first involved in the management of patients with colon cancer.

DAVID R. MARKS, MD: But from the decision on what treatment to follow, obviously the patients and the families must play a very important role, in your experience.

MARK POCHAPIN, MD: Oh, yeah. There's definitely a team approach here. Initially, the patient is sort of thrown into this colon cancer diagnosis, usually after they have a procedure like a colonoscopy, where either a growth or a mass is found. And then a CAT scan or some other imaging study is done to look if that cancer has spread.

If it's spread, then the oncologist may need to be involved upfront. If it hasn't spread, then the surgeon may try and resect the entire thing. And the pathologist is someone who looks at the tissue under a microscope, and is going to help you decide whether the tumor requires more therapy like chemotherapy. So it's really an approach that requires a lot of different people in a center.

DAVID R. MARKS, MD: We have a number of examples we're going to run through to try to see which way you'd go, and who you'd really turn to to make a decision. Let me run a couple of cases by you.

The first one is a 35-year-old woman with a history in her family of colon cancer, who complains of rectal bleeding, and she's found to have a polyp on colonoscopy. Who's involved in the treatment decisions?

MARK POCHAPIN, MD: Usually that's done right at the time of the diagnostic colonoscopy. The nice part about doing a colonoscopy in someone with a family history, is that if you find a polyp, it can be removed right there and then at the time of the diagnostic colonoscopy, making it a therapeutic procedure as well.

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