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Colon and rectal cancer diagnostic tests

Colorectal Cancer Diagnostic tests

Determining the stage of colorectal cancer.

If you or a loved one start experiencing the signs and symptoms of colon or rectal cancer, your physician will conduct tests to confirm or rule out the possibility of colorectal cancer.

A correct diagnosis of colorectal cancer is very important. It will help your healthcare team determine what stage the colon or rectal cancer is in. And it will also help determine your prognosis and treatment options. Here are some of the tests used to determine the stage of colon or rectal cancer:

  • Biopsy: During a colonoscopy or sigmoidoscopy, an abnormal growth may be found from which doctors will want to take a sample of tissue, or a biopsy. This sample may come from the colon and/or rectal area.
  • Blood tests: No blood test can definitively detect colon cancer, but your doctor may order them to better understand what may be causing your symptoms.
  • Chest X-ray: X-rays of the chest can show whether cancer has spread to the lungs.
  • Colonoscopy: A thin, flexible tube with a light and camera attached is gently inserted through the rectum into the colon so the doctor can view the entire length of your colon for any other abnormal areas. A colonoscopy is recommended every 10 years.
  • CT scan: An X-ray machine linked to a computer takes a series of detailed pictures of areas inside the body. The patient may receive an injection of a contrast dye, which will help outline abnormal areas in the body on the scan. Tumors in the liver, lungs, or other places in the body show up on the CT scan.
  • Digital rectal exam (DRE): A test in which a doctor or nurse will insert a lubricated, gloved finger into the rectum to check for lumps or abnormal areas.
  • Double-contrast barium enema (DCBE): In this test, a series of colon and rectum X-rays are taken. The patient is given an enema with a barium solution, and air is pumped into the rectum. The barium and air outline the colon and rectum on the X-rays. It detects approximately 30% to 50% of the cancers found with standard colonoscopy, and may miss small polyps.
  • Endorectal ultrasound (EUS): An ultrasound probe is inserted into the rectum. The probe sends out sound waves (out of range of human hearing) that bounce off the rectum and nearby tissues. During an endorectal ultrasound exam a computer-generated picture, created from the echoes, shows how deep a rectal tumor has grown or if the cancer has spread to lymph nodes or other nearby tissues.
  • Fecal occult blood test (FOBT): A stool sample is examined for blood.
  • Sigmoidoscopy: The rectum and lower colon are examined with a lighted instrument. Precancerous and cancerous growths found can be removed or biopsied for further investigation.
  • Magnetic resonance imaging (MRI): Your doctor may also use other tests, such as MRI, to see if the cancer has spread. A contrast material is often injected into a vein before the scan to make details easier to see.
  • Lymph node sampling: The lymphatic system is a network of organs, lymph nodes, lymph ducts, and lymph vessels. It is a major component of the body’s immune system. Lymph nodes are small bean-shaped collections of immune system cells clustered at various points of the body.

Because colon and rectal cancers often spread to nearby lymph nodes, ideally your doctor will take a biopsy of at least 12 lymph nodes to check for disease. This helps show how far the cancer has spread.

Sampling at least 12 lymph nodes is important because:

  • it can give doctors a more accurate diagnosis of your condition
  • it helps your medical team make informed treatment decisions, which may lead to a better survival rate for you

Learn about the treatment options for colon and rectal cancer.

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US.XON.10.04.019 Last Update: May 2010