How Do You Choose the Right Colon Cancer Treatment?

Doctor speaking with patient
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You've been diagnosed with colon cancer. Why do you feel as if you heard the blast of a gun and the race has started? Many patients have explained to me, as their nurse, that from the moment they were diagnosed with cancer they knew that they just "wanted it out" -- and wanted it out quick. However, the rushing to make a treatment decision might not be your very best choice in the long run.

Unless your doctor has explained differently, you probably have some time -- not months or years -- but at least days and weeks to get a second opinion if you want one.

Since getting diagnosed with colon cancer you have probably already met with your primary care doctor, a gastroenterologist, and possibly even an oncologist, or a doctor that specializes in cancer treatment. You may have already talked to a surgeon as well, if your gastroenterologist encouraged surgery to remove your colon cancer.

Assuming that you have a non-medical background, the majority of professional opinions coming at you can be overwhelming and confusing. Understanding what and where each medical professional enters your story might help you conceptualize how treatment options are created.

Primary Care Physicians

Your primary care doctor, or primary care physician (PCP) is the entry point for the entire process. He or she is the one who decides if colon cancer screening is appropriate or necessary. The PCP may order some tests, such as x-rays, blood or stool testing, or the doctor may decide to immediately refer you to a gastroenterologist.

Most insurances require that your PCP remains as the overarching doctor during the entire treatment process. Although you will not be going to see him or her for the actual treatments, the PCP is usually responsible for writing all of the referrals -- like to the surgeon or oncologist -- and remains involved in monitoring your care throughout treatment.


A gastroenterologist is a medical doctor that specializes in the gastrointestinal system. This doctor has advanced schooling and experience in the diagnosis and treatment of any issues of your entire digestive tract and associated organs, such as the pancreas. These doctors are well-versed in caring for diseases and conditions of your:

A specially trained gastroenterologist is the doctor who will actually perform your colonoscopy or sigmoidoscopy, as well.


Following your colonoscopy, if a biopsy was obtained, another type of doctor called a pathologist will become involved in your case. The sole purpose of the pathologist is to examine your colon tissue samples. This highly trained doctor is integral in helping to determine the stage and grade of your cancer. He or she will then forward a pathology report -- a report that details the type, size, and everything there is to know about your cancer cells to your PCP and to the gastroenterologist.

This report helps to specialize your treatment options to what would best treat your cancer.

Hearing About Your Treatment Options

At this point, you and your doctors will decide whether you are going to visit with an oncologist, a radiologist, or a surgeon for treatment. Perhaps you will visit all three -- that is not unusual depending on the staging of your colon cancer, or basically how advanced it has become. You will receive treatment options and in some cases, a combination of treatment options will be offered including:

Or a specific combination of the aforementioned treatment modalities (such as radiation to first shrink a large rectal tumor followed by surgery to remove it).

Making the Decision

Now comes the hard part -- no one can make the final decision about treatment except for you. Your doctors can provide recommendations. Friends can provide historical accountings of what worked for a friend. Loved ones can help encourage and support you. However, only you have the final say in treatment choices. Your doctor cannot force you to do anything. He or she can only tell you, based on the most recent data available about someone your age with your type of cancer, how effective each treatment may -- or may not -- be.

Ask Questions

The best way to advocate for yourself is by learning more about your type of colon cancer and what each treatment option means. The doctor talking to you about treatment recommendations is the best place to start this learning curve. If you don't understand a treatment or its side effects -- or even how it might affect your day to day wellness -- do not hesitate to ask.


National Cancer Institute. (n.d.). Treatment Options for Colorectal Cancer. Accessed online September 14, 2014.

American Cancer Society. (n.d.). Treatment by Stage of Colon Cancer. Accessed online September 15, 2014.

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