What is the protocol for chemotherapy for colon cancer?

Skorpio48 asked...

What is the protocol for chemotherapy for colon cancer? Eighteen inches of colon has been removed and only one lymph node out of 17 shows cancer cells.

Expert Answer

Ernest Rosenbaum, MD, is an oncologist affiliated with Stanford University and with the Comprehensive Cancer Center at the University of California, San Francisco, where he has developed protocols for supportive care and clinical practices.

Colon cancer is typically treated first with surgical removal, then with chemotherapy if the doctor considers it necessary. (Almost 50 percent of all patients can be cured with resection alone.) The chance for a cure and the role of chemotherapy is determined by how far the tumor has invaded through the bowel wall and spread to theĀ  lymph nodes. If the cancer has spread to the lymph nodes (even one) the incidence of recurrence is higher. When the cancer is located in the rectum, radiation is often advised.

Without knowing more about exactly where your cancer was located, it's not possible to provide a specific protocol. However, for most patients, adjuvant or follow-up chemotherapy improves long-term survival rates. Studies show that when treated with surgery alone, 20 to 25 percent of Stage II cancers and 40 to 90 percent of Stage III cancers will recur. One common chemotherapy regimen for lymph node-positive colon cancer is 5-FU combined with leucovorin, but there are several possibilities. Talk to your doctor and ask her to speak openly with you about the staging and prognosis for your cancer, and about what kinds of results you can expect from each treatment option. If you are not happy with your doctor's recommendations or communication style or simply wish to have more information, it's always a good idea to get a second opinion.