# Care pathway for colon cancer On this page you will find information about the different stages of examinations and treatment of colon cancer at HUS. ## [ From symptoms to diagnosis ](#from-symptoms-to-diagnosis) ## [ Getting a diagnosis ](#getting-a-diagnosis) ## [ Treatments ](#treatments) ## [ After treatments ](#after-treatments) ## [ Support and information ](#support-and-information) ## From symptoms to diagnosis Primary health care ### A symptom appears or an abnormal finding is made --- The suspicion of colon cancer usually arises with altered bowel function. Symptoms may include abdominal pain, dark blood in the stools or anemia, i.e. low hemoglobin levels, due to slow blood loss, . A fecal blood test used for diagnosis and screening can reveal a tumor that causes bleeding. Sometimes an intestinal tumor can also be detected in an imaging examination of the abdominal area. ### Required additional examinations in primary health care and a physician’s assessment --- Colon cancer is usually diagnosed with the help of a tissue specimen taken during an endoscopic examination, i.e. colonoscopy. ### A physician writes a referral --- If colon cancer is suspected or after it has been diagnosed, a physician will refer you to the HUS gastrointestinal surgery unit. ## Getting a diagnosis Comprehensive Cancer Center and other specialized medical care ### The referral arrives at specialized medical care and an invitation is sent to the patient --- A surgeon will plan the necessary additional examinations based on your referral. As additional examinations, we usually book you a computed tomography examination and laboratory testing. You will be notified of your appointment and your X-ray and laboratory examinations by letter. Along with the letter, you will receive a preliminary information form, which we hope you will fill in and bring with you to your appointment at the surgery outpatient clinic reserved for planning your treatment. The nurse coordinating your treatment will schedule your outpatient clinic appointments and the required examinations, and will contact you by phone. It is a good idea to reserve plenty of time for the appointment day, as you will meet with a surgeon, an anesthesiologist, and a nurse. You can also bring a loved one with you to your appointment. [ See the average treatment wait times for bowel cancer here ](/en/patient/treatments-and-examinations/cancer/access-cancer-treatment) ### If necessary, additional examinations can be carried out --- We will perform the necessary additional examinations and administer an intravenous iron medicine for you. A CT scan of your body will give us information on the exact location of the tumor, whether it has spread to surrounding tissues, and whether it has metastasized. If the tumor is located in the rectum, we will also perform an MRI scan that will give us detailed information about its local spreading in the pelvis minor area of the pelvis. We will also take necessary blood tests, such as a small blood count (PVK), tumor marker (CEA), and a kidney function test (Krea). In particular, changes in tumor marker concentration after surgery and during follow-up can provide valuable information to support treatment decisions. You have the blood tests taken in any HUS laboratory. ### Appointment with a physician and a nurse --- At the outpatient clinic appointment preceding surgery, you will meet with the surgeon, who will review your examination results with you and provide more information on your treatment plan. The purpose of the appointment with the anesthesiologist is to devise an anesthesia regime suitable for you, meaning the general anesthesia and pain management. At the nurse’s appointment, you will discuss your treatment plan and receive instructions on how to prepare for surgery. [ Read more about appointments with a physician and a nurse in the diagnosing of … ](/en/patient/treatments-and-examinations/cancer/care-pathway-colon-cancer/appointments-physician-and) ## Treatments Specialized medical care ### Treatment begins --- Local colon cancer refers to cancer confined to the colon or the mesenteric lymph nodes near the colon. We treat localized colon cancer primarily with surgery. Colon cancer surgery is performed at Jorvi Hospital. [ Read more about the treatment of localized colon cancer ](/en/patient/treatments-and-examinations/cancer/care-pathway-colon-cancer/treatment-local-colon-cancer) ### Healing and follow-up --- We plan your follow-up program in accordance with your tumor type and general physical condition. Colon cancer follow-up usually continues for the first two years at HUS and after that in primary health care. If the colon cancer has a high risk of recurrence, follow-up will continue at the HUS surgery unit after a two-year follow-up period. If necessary, your colon cancer follow-up will continue at the Comprehensive Cancer Center based on the oncologist’s assessment. The follow-up includes symptom surveys, clinical examinations, blood tests, colonoscopy and, in some cases, imaging examinations. In between follow-up visits, you can contact the unit that treated you if you have any questions. ### If the disease recurs or treatments do not help --- Sometimes colon cancer recurs despite initial surgical and drug treatments. The cancer may have already spread more widely when initially diagnosed, usually to the liver or lungs. The treatment of metastatic colon cancer aims to effectively slow down the disease and, hence, maintain as good a quality of life as possible and prolong life expectancy. In some situations, we will also remove metastases surgically. This makes it possible to achieve long periods when the disease does not require treatment. The treatment method we primarily use for metastatic colon cancer is chemotherapy, which we administer either as tablets, by intravenous infusion, or a combination of these. In addition to chemotherapy, we can use growth factor inhibitors to either prevent growth triggers from being transmitted to cancer cells or to the cells that generate new blood vessels for tumors. [At the Clinical Trial Unit](/en/patient/hospitals-and-other-units/comprehensive-cancer-center/clinical-pharmaceutical-research-unit "Clinical Trial Unit, Comprehensive Cancer Center") we offer an increasing number of patients the opportunity to be among the first to receive new research treatments. ### Palliative care and psychosocial support --- Most bowel cancers can be cured permanently. With some patients, the cancer recurs or it is found to be metastasized early on. A metastatic cancer is one that has caused remote tumors to appear in other internal organs or in the bones. Palliative care to alleviate the symptoms will be given alongside chemotherapy and will be continued once the chemotherapy is discontinued and symptomatic therapy is introduced. In this case, treatment aims to alleviate symptoms and, as far as possible, to ensure a good and active life with the illness until death. Typically, at this stage, your care responsibility is transferred to the Palliative Care Unit or to the palliative outpatient clinic or hospital-at-home unit in your area. Good palliative care and psychosocial support are an integral part of cancer treatment. The Palliative Care Center provides help in the stressful life situation caused by the cancer treatments, assistance in treating the difficult symptoms, and, if needed, also conversational support. [ Read more about the Palliative Care Center ](/en/patient/hospitals-and-other-units/comprehensive-cancer-center/palliative-center-comprehensive) ## After treatments ### Follow-up in specialized medical care ends --- Your follow-up after treatment at HUS for local colon cancer usually lasts for two years, after which your follow-up in specialized medical care ends. After this, endoscopic follow-ups are performed in primary health care in accordance with the instructions given by the HUS abdominal surgeon. There is usually no need for regular blood tests or marker monitoring after the completion of follow-up visits in specialized medical care. ## Support and information Getting cancer is a big life change. Here you will find information and support for living with the disease. ### [ Support during cancer treatment ](/en/patient/treatments-and-examinations/support-during-cancer-treatment) Here you can find discussion help and support for rehabilitation for cancer patients.  ### [ Instructions and additional information for cancer patients ](/en/patient/treatments-and-examinations/cancer/instructions-and-additional-information-cancer-patients) Here you will find our patient guide and more information about cancer treatments.  Updated: 10.10.2024