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Dr. Mark F. Kozloff: Once the diagnosis of colon cancer is made, one does clinical staging
and what should do besides the colonoscopy, you have the CAT scan with physical exam,
blood test, and then, once one knows what the clinical stage is, a treatment decision
is made. If a person is stage 1, 2, or 3 meaning that the cancer is confined to the colon or
confined to the colon in nearby lymph nodes, the primary treatment is that of surgery and
than one may add on afterwards that of chemotherapy depending upon what the pathological stage
is. That’s the findings at the time surgery in which that if one is stage 1, all that
is needed is a surgery, if a person is stage 3, then one gets the surgery and offers what
we call adjuvant chemotherapy. Chemotherapy in addition to surgery to increase the chances
of cure by going after disease that one cannot see. For person who is stage 2, sometimes
people offer chemotherapy as an adjuvant, sometimes not and there is a situation where
Oncotype DX maybe helpful in delineating the exact prognosis in stage 2 to help the side
on adjuvant therapy. If a person is stage 4 at the time of diagnosis, meaning the CAT
scan has shown spread to the liver or the lung, the primary treatment is that of chemotherapy
and not surgery and surgery or radiation can be used to treat localize symptomatic problems,
but again you want to have a treatment that goes through the blood stream and goes to
the cancer wherever it is. So the treatment will change depending upon both the clinical
as well as the pathological stage of the illness.