At the Colon and Rectal Cancer Center at Dana-Farber Brigham Cancer Center, our many specialists manage your diagnosis as a team. Our gastroenterology, radiology, and pathology experts specialize in gastrointestinal cancer imaging and diagnostics. This gives us in-depth experience with the disease process and an extraordinary depth of knowledge.
If you are diagnosed with colon cancer, our team often uses a series of tests to better help understand the extent of the disease and determine the right treatment for you. Some or all of these tests are needed to stage (find out the extent of) the cancer:
- History and physical exam: Taking a thorough medical history is important to help make a treatment plan appropriate for your body and your goals. Your health care provider examines your body to check general signs of health, including signs of disease, such as lumps and swollen lymph nodes.
- Blood chemistry studies: Your doctor takes a blood sample to check the amounts of certain substances released into the blood by organs and tissues in the body.
- Complete blood count (CBC): Your doctor takes a sample of blood to check for the number of red blood cells, white blood cells, and platelets.
- Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of colon cancer and can be used to determine how a patient's treatment is progressing.
- Biopsy: If you were diagnosed by a sigmoidoscopy or colonoscopy, a biopsy was likely already taken and sent to pathology to look at the cells under a microscope. However, after diagnosis, other biopsies may be needed if abnormalities are found elsewhere in order to test determine the right treatment.
- Radiology exam: Common radiology procedures include:
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine.
- MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed images of areas inside the body.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the image because they are more active and take up more glucose than normal cells.
Our radiologists are leading advanced research to develop better diagnostic tools to study cancer and determine how treatments affect the cancer.
Our team regularly publishes its findings about the use of imaging for diagnosis, treatment response, and clinical management of cancer care.
- Our team has published hundreds of articles on cancer imaging in the past three years.
- We are investigating new approaches to cancer imaging, including dual energy CT. This research can optimize our understanding of this kind of cancer and help determine whether or not to operate.
- We are studying the impact of new treatments such as immunotherapy and how best to image response to newer treatments.
Dana-Farber Brigham Cancer Center pathologists review your pathology slides (even if an outside hospital already reviewed them) to make sure there is agreement on your exact diagnosis.
- Our pathologists are leaders in the field of gastrointestinal cancer and have authored more than 500 original publications.
- They work closely with our Center for Molecular Diagnostics to get a complete picture of your tumor in order to direct the right therapy, based on both the tumor type and the molecular features of the cancer.
Precision Cancer Medicine
Clinicians at Dana-Farber Brigham Cancer Center are now armed with specialized tests to create a precise "tumor profile" for each patient's cancer.
If you have been diagnosed with colon cancer, it is important to be seen quickly to start timely treatment. We are committed to seeing patients for an initial diagnosis or second opinion within days. We will assemble the team of specialists that is right for your stage and type of colon cancer.
The process used to find out the extent of the cancer within the colon, or if it has spread to other parts of the body, is called staging. This determines your prognosis and your treatment plan.
There are three ways through which cancer can spread (metastasize) in the body: tissue, the lymph system, and the blood:
- Tissue: The cancer spreads from where it began by growing into nearby areas.
- Lymph system: The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood: The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Some staging can be done before having surgery, and other parts of the staging process are done after the cancer is removed from the colon. During your first meeting with your team at Dana-Farber Brigham Cancer Center, we will discuss with you the best strategy to stage your cancer.
Colon cancer can be assigned one of these stages:
Stage 0 (Carcinoma in situ): Abnormal cells are present in a polyp, but have not invaded into the colon wall.
Stage I: Cancer has spread from the innermost layer of the colon wall (submucosa) or the muscle layer, but there is no spread to lymph nodes or distant organs.