Colon cancer is the second leading cause of deaths resulting from cancer. Every year, approximately 48,000 people will die in the U.S. from colon cancer. Many of these deaths would be prevented with early detection and treatment through routine colon cancer screening.
Colon cancer progresses through stages
The stage of the colon cancer determines the appropriate treatment and determines the individual's relative 5-year survival rate which is the percentage of colon cancer patients who live at least 5 years after being diagnosed.
Colon cancer progresses in stages as follows:
- Stage 0: The disease starts as a small non-cancerous growth, called a polyp, in the colon. Some of these polyps become precancerous, and over time, turn cancerous. Growth has not progressed beyond the inner layer (mucosa) of the colon.
- Stage 1: The cancer has started to work its way through the first layers of the colon (the mucosa and the submucosa).
- Stage 2: The cancer has advanced beyond the first two layers of the colon and is spreading deeper through the wall of the colon into the muscularis and the serosa but is not in the lymph nodes or distant organs.
- Stage 3: The cancer has spread to one or more of the nearby lymph nodes.
- Stage 4: The cancer has spread to other organs (typically the liver or the lungs).
Screening for colon cancer
In order to detect colon cancer early, everyone, even individuals who are not at high risk, that is, with no symptoms and with no family history of colon cancer, should be screened. Cancer specialists suggest that screening for such individuals start at age 50 and consist of tests that detect colon cancer in the body:
- Colonoscopy, at least every ten years,
- Sigmoidoscopy, at least every 5 years,
- Double-contrast Barium Enema, at least every 5 years, or
- Virtual Colonoscopy (computed tomographic colonography), at least every 5 years.
These tests allow a doctor to actually see the growth or cancer inside the colon. The frequency at which these tests are repeated depends on what is found during the procedure.
Cancer specialists also recommend tests that look for blood in the stool, such as:
- Annual Guaiac-based Fecal Occult Blood Test (gFOBT)
Such tests detect the presence of blood from tumors in the stool. Generally these tests are not as effective at detecting colon cancer as those that detect cancer in the body.
Stage of colon cancer determines treatments and relative 5-year survival rates
If the disease is detected as a small polyp during a routine screening test, such as a colonoscopy, the polyp can usually be taken out during the colonoscopy without the need for the surgical removal of any of the colon.
When the polyp becomes a tumor and reaches stage 1 or stage 2, the tumor and a portion of the colon on both sides is surgical removed. The relative 5-year survival rate is over 90% for stage 1 and 73% for stage 2.
If the disease advances to a stage 3, a colon resection is no longer sufficient and the patient also needs to undergo chemotherapy. The relative 5-year survival rate drops to 53%, depending on such factors as the number of lymph nodes that contain cancer.
By the time the colon cancer reaches stage 4, treatment may require the use of chemotherapy and other drugs and surgery on multiple organs. If the size and number of tumors in other organs (such as the liver and lungs) are small enough, surgery may be the initial treatment, followed by chemotherapy. In some cases the size or number of tumors in the other organs takes away the option of surgery as the initial treatment. If chemotherapy and other drugs can reduce the number and size of these tumors, surgery may then become an option as the second form of treatment. If not, chemotherapy and other drugs (possibly through clinical trials) may temporarily stop or reduce the continued spread of the cancer. The relative 5-year survival rate drops to approximately 8%.
As the relative 5-year survival rates indicate, the time frame in which colon cancer is detected and treated makes a dramatic difference. If detected and treated early, the individual has an excellent chance of surviving the disease. As detection and treatment is delayed, the odds start turning against the individual so that by the time the colon cancer progresses to Stage 3, the percentage is almost even. And the odds drop precipitously when the colon cancer reaches stage 4.
Failure to screen for colon cancer may constitute medical malpractice
Unfortunately, all too often doctors do not recommend routine colon cancer screening to their patients. By the time the cancer is discovered - often because the tumor has grown so large that it is causing blockage, because the patient has unexplained anemia that is getting progressively worse, or because the patient begins to notice other symptoms - the colon cancer has already advanced to a stage 3 or even a stage 4. The individual now faces a much different prognosis than if the cancer had been detected early through routine screening. In medical malpractice terms, the individual has suffered a "loss of chance" of a better recovery. That is to say, because the doctor did not advise the individual to undergo routine screening, the cancer is now much more advanced and the individual has a much reduced chance of surviving the cancer.
The failure of a doctor to advise the individual about screening options for colon cancer may constitute medical malpractice.
Contact a lawyer today
You need to contact a lawyer immediately if you feel there was a delayed diagnosis of colon cancer due to a doctor's failure to recommend routine colon cancer screening. This article is for informational purposes only and is not intended to be legal (or medical) advice. You should not act, or refrain from acting, based upon any information at this web site without seeking professional legal counsel. A competent lawyer with experience in medical malpractice can assist you in determining whether you may have a claim for a delay in the diagnosis of colon cancer due to a failure on the part of the doctor to offer colon cancer screening. There is a time limit in cases like these so do not wait to call.