The colon is a part of the human large intestine, the last portion of the digestive tract before it culminates into the rectum. If you have got to the topic, I am sure you are already aware of it. With the information of a near and dear one suffering from colon cancer, more often than not we are stunned. It becomes difficult to decide where to start with certainty. Be certain of one thing, reading about it helps a lot.
Today we will focus on understanding more about how to understand the disease response within a patient once onset has begun. Another important discussion will be around how well and for how long does a person survive post disease onset.
As in the case of most of the cancers, the prognosis and life expectancy depends on:
- Stage of cancer detection – Localized stage 0 cancers present with a better outcome than distant-stage three or four tumors. As early is the detection, better is prognosis more is the life expectancy.
- Grade of cancer – Higher the grade more is the difference between normal and cancer looking cells worse is the prognosis.
- Lymph nodes involvement – Lymph is the channel through which cancer metastasize. More number of lymph nodes involved worse is the prognosis.
- Age – More the age, worse the prognosis.
- Size and location of tumor – If the location or size of the tumor is such that it blocks the colon or the opposite like lead to a hole in colon, both of which affect the prognosis adversely.
- General health condition of the individual – Better is the patient health likely they are to bear with cancer treatment and turn out cancer-free.
- Carcinoembryonic antigen – It is a protein molecule found in the blood. With colon cancer, the blood CEA levels may increase which consequently affects a patient’s response to treatment.
According to a study conducted by an Indian setup across one whole year, the mean age of colon cancer patients was detected to be around 49.1 years. There is variance in all prognosis related numbers of India to that of the West, including the nutritional status of a patient.
|Sr. No.||Prognostic Indicator||India||West|
|1||Age of Onset men||Mean age 49||68|
|2||Age of Onset women||72|
|3||Age of detection||Late||Early|
|5||Five-year survival rate||<40%||65%|
Even at the same age, the prognosis of each individual is different.
Survival rates are the percentage of individual survived after colon cancer detection. Five-year survival rates are the percentage of people alive after five years of disease detection. The relative survival rate is the survival rate as compared to a normal individual of the same age without the disease.
Survival rate based on location:
- Localized colon cancer is the one detected in stage 0 well captured in the organ of origin. The known five-year relative survival rate of such colon tumors is 90 percent.
- Regional colon cancer is the one that has metastasized to a different part of the body (stage 2 and 3). The known five-year relative survival rate of such colon tumors is 71 percent.
- Distant is the one that has metastasized to a different part of the body (stage 4). The known five-year relative survival rate of such colon tumors 14 percent.
These rates are attributed to worldwide data without delayed detection, socioeconomic status, and nutritional factors hampering the outlook.
Indian Statistics for Colon Cancer:
- Out of the total people affected with colon cancer, sixty-five percent were reported to be males.
- The average period of the symptomatic presentation was around 4 months before the exhibition.
- The median CEA (Carcinoembryonic antigen) level was 8 ng/ml.
- Most patients demonstrated localized or locally advanced disease.
- Twenty-eight percent of the patients had metastatic disease with the liver being the commonest site of metastases (14%) followed by peritoneum and lung.
- More than half of the patients received treatment with curative intent.
- More young patients and more patients presenting with an advanced stage. Most patients (50.7%) were detected at stage III disease.
- Inadequate access to healthcare and socioeconomic factors may play a role in some of these differences.
- The five-year survival rate of Colorectal Cancer in India is one of the lowest in the world at less than 40%.
The difference in the prognosis and survival rates reveals that the problem isn’t the treatment, the problem is the detection and other factors which when eliminated, prognosis parameters can be turned around.
Dr. Vikas Jain, Senior Consultant – Kidney Transplant – Adult, Kidney Transplant – Paediatric, Urology | Dharamshila Narayana Superspeciality Hospital, Delhi & Narayana Superspeciality Hospital, Gurugram