Tests and Stages of Colon Cancer

Once suspected, next, colon cancer needs a massive series of tests for confirmatory diagnosis, as well as a proper staging to determine the treatment protocol. Each stage of cancer responds differently depending upon its condition, for example: if the cancer is confined, surgery can be performed to cut out the affected part of the organ, however, if lymph node involvement is observed, further treatment such as radiation may be provided to control the spread.

1.Tests and Procedures

To determine the severity as well as the proper treatment for colon cancer, your doctor may advise you to get any of the following tests and procedures:

Blood Tests

There are several tumor markers that may be detected in the blood when an individual is suffering from cancer of the colon. In colon cancer, the carcinoembryonic antigen (CEA), which is found only in fetuses, may be elevated. Detection of elevated amounts of CEA in the blood suggests the presence of colon cancer.

Complete Blood Count (CBC) 

A procedure wherein a sample of blood is drawn and tested to determine the number of red blood cells, white blood cells, and platelets, hematocrit, and hemoglobin.

Imaging Tests 

Chest X-ray

These radiographs help doctors determine whether metastasis has reached the lungs.

MRI (Magnetic Resonance Imaging)

Also known as Nuclear Magnetic Resonance Imaging (NMRI) is a diagnostic procedure that uses magnets, radio waves, and a computer to make consecutive sliced pictures of the areas of the colon. Gadolinium (a contrast dye), is injected into your vein. This substance will surround the colon cancer cells and will glow brighter in the pictures.

Positron Emission Tomography Scan (PET scan)

Another procedure that determines a number of cancer cells in the body. A radioactive sugar is injected into your vein. The individual is placed in a PET scanner, which rotates around the body to detect areas in the body where radioactive glucose is being utilized. Malignant tumors are expected to glow brighter.

CT scan

A CT scan is a painless procedure that uses a radiographic machine which is linked to a computer. It takes a series of detailed images in Dzslicesdz within the body. A dye may be injected before the procedure. This process will be helpful in determining whether cancer has spread to other organs of the body, specifically, the liver.


Endorectal Ultrasound – Like colonoscopy, endorectal ultrasound provides another means of visualizing to the rectum and the colon. An ultrasound probe is inserted into the rectum. The probe then sends ultrasonic sound waves, which will bounce off the rectum and create images in a computer.


It is a procedure that uses a special scope that attempts to gain a visual of the actual bowel wall. It allows the specialist to see any abnormalities found in the colon as well as the rectum using a device called a colonoscope. Biopsy

Lymph Node Biopsy Because lymph node involvement is an integral component in determining the stage of colon cancer, lymph node biopsy is needed to detect the presence of cancer cells in nearby lymph nodes.

Questions to Ask Your Doctor

Consider the following questions that you may want to ask your doctor during consultation:

Where is the exact location of my cancer?

Based on my diagnosis, what are the possible treatment options?

Are there clinical trials that are open to me?

Do you have any treatment option that you would like to recommend to me? Why?

Who will be the members of my health team? Can you explain the functions or role of each member?

Who will coordinate my entire cancer therapy as well as my follow-up visits?

If I have concerns about the costs of my cancer treatment, who do you think can help me with my concerns?

When I’m diagnosed with colorectal cancer, should my relatives be screened for colon cancer as well?

2.Staging and Grading 


Once colon cancer has been confirmed, further testing is needed to determine the severity and prognostic evaluation of cancer. This process is called staging. It determines if cancer has spread and if it has how much of cancer has spread. The information obtained from these staging studies will be invaluable in deciding the course of treatment and the possible response of cancer in the different forms of cancer therapy.

The process of staging is based on the knowledge of how colon cancer progresses. Cancer cells have an uncontrolled growth and grow in a much disorganized fashion. In effect, they evolve and form a mass of tissue known as a tumor. As this mass of tissue becomes bigger, it gains the capacity to invade the neighboring tissues. Once it obtains access to the lymphatic or the blood stream, they may be given a free ticket to other areas of the body, where they can cause further damage. This capacity of cancer cells to spread is called metastasis and is what is measured in staging.


The stage describes the size and the amount of metastasis of the colon cancer. Grading on the other hand, describes the degree of similarity of the cancer cells to the tissue of origin microscopically. As a general rule, the more the cancer cells resemble the tissue of origin, the better the prognosis. Both the stage and grade of the colon cancer can be determined only after surgery and when a tissue has been obtained for viewing under the microscope (i.e. Biopsy). These may be determined using two classification systems the Duke Staging System as well as the TNM Staging System.

Common Elements of Staging Systems

Along with the advancement of colon cancer research and technology, staging systems for colon cancer continue to evolve as well. Now, oncologists may use several different systems in determining the stage of cancers. Some of these systems will focus on specific types of cancer; others are more applicable to different types of cancer.

However, regardless of the staging system used, all systems have the following basic elements:

Location of the primary tumor

The size and number of the tumor/s

The degree of lymph node involvement

The degree to which cancer cells resemble normal cells of the tissue of origin

Presence or degree of metastasis or spread

Dr. Adem Gunes
Dr. Abdullah El-Hossami