Michael F. Driscoll, M.D., medical oncologist with Norton Cancer Institute, answers the question, how is colon cancer diagnosed?

Colon cancer typically is diagnosed from some kind of clinical presentation. Most often times people will present with some kind of gastrointestinal bleeding usually either rectal bleeding or potentially dark tarry stools which we call melena. Sometimes people will have abdominal pain as well. Oftentimes if people present with these types of symptoms they’ll either be referred to a gastroenterologist or maybe their primary care physician will set them up for a CAT scan of the abdomen. Let’s say if they get a CAT scan first they may find that there is a mass in the colon somewhere but that’s not diagnostic of the cancer because you still need a pathologic specimen, which is a biopsy of the tissue. Invariably most people get referred to either a surgeon or a gastroenterologist where they get a colonoscopy. They get a colonoscopy and then typically they would find some abnormality – be either a mass or some abnormality – which is indicative of a cancer and they take a biopsy. That biopsy then gets to a pathologist and the pathologists will look at the tissue specimen underneath a microscope and they’ll tell us if it’s cancer and that so what kind. Typically it’s adenocarcinoma. Staging is the next step. Staging typically involves CAT scans. We would get CAT scans usually at the abdomen and pelvis and oftentimes chest to make sure that the cancer hasn’t spread anywhere else. Staging really kinda depends on what mode of treatment we’d undergo next. For most people we’re gonna check blood levels as well, tumor markers and then, once we stage it up, that tends to tell us what the patient then needs as far as treatment.

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