Stage 1 Colon Cancer

Dr. Timothy Hoops
Last Modified: November 1, 2001

Dear OncoLink "Ask the Experts,"
Hello, I am a 35-year-old female. I was diagnosed with Stage I colon cancer last year. My sister who is 45 was diagnosed 4 years ago in stage 4. We just found out that the cancer has spread to her liver and lungs. I am very scared. Does this mean I will have a recurrence? 6 Months ago 2 polyps were removed from my rectum and anus (which is where my sister's cancer started). I feel hopeless. Can I survive colon cancer?  
Thank you!

Dr. Timothy Hoops, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:

First of all, I'm very sorry to hear about your sister. Your distress about her and yourself is very understandable. Although we cannot comment on yours or your sister's specific case, assuming that the staging information you have presented is correct and complete, your situation appears different from hers. You had a stage 1 cancer that indicates it was isolated to the inner lining of the colon without any positive lymph nodes. The chances that surgery alone cured this cancer are overwhelmingly in your favor. No one can predict the future and a very small percentage of patients with Stage 1 cancer may develop advanced disease but this is rare. The polyps that you had removed were presumably adenomas, which are benign. In fact, this is what you want to find as they may have progressed to cancer if you had not had them removed.

A more important question is why you and your sister had colon cancer at such an early age. This may be an inherited colon cancer syndrome. They reason to define this is that decisions regarding treatment, and subsequent surveillance programs can be tailored to your specific situation. Clearly you need follow-up colonoscopies but the frequency may be different depending on your family history. I would strongly recommend that you find a center, similar to our Gastrointestinal Cancer Risk Evaluation Program here at the University of Pennsylvania that provides genetic counseling and possible genetic testing to better define your future risk.