Editing Patient Pathways: Colon Cancer (section)

= Patient pathway =

Developing a comprehensive plan for the treatment of colon cancer includes steps from initial presentation and diagnosis to treatment and follow-up. Below is a detailed plan:

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== 1. Diagnostics ==

The patient presents with symptoms such as blood in the stool, increased abdominal discomfort, changes in habits - hardness, color or frequency of stools, unexplained weight loss, prolonged fatigue and unexplained weakness of the intestines, general or localized abdominal pain.

'''Consultation with a general practitioner (GP):''' The patient visits a general practitioner. 

'''Medical history and physical examination:''' Detailed patient history. 

'''Initial tests:''' colonoscopy and non-invasive tests.

'''Referral to a specialist''' Referral to a radiologist and oncologist.

'''Diagnostic evaluation'''

'''Hemoccult:''' Detects blood in the stool that is not visible to the naked eye - it is used as the basis for screening in Croatia. 

'''Colonoscopy:''' a method by which the doctor examines the inside of the entire large intestine and during which it is possible to remove smaller polyps and see suspicious formations. 

'''Radiological blood tests (CT, NMR, Lung X-ray, PET CT):''' Gives us information about the local spread of the disease and possible metastases. 

'''Blood tests:''' CEA, CA 19-9: tumor markers, give us information about the presence of cancer cells 

'''CKS:''' detects anemia (‘anemia’) which occurs due to bleeding from the tumor into the interior of the intestines 

'''Genetic tests:''' We use them when the patient is of a younger age or if there is a family history of that or related types of cancer.

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== 2. Treatment ==

'''Multidisciplinary Team (MDT) meeting'''

'''MDT discussion:''' Review of diagnostic findings with specialists including endocrinologists, surgeons, oncologists, radiologists and pathologists. Development of a treatment plan: Based on the stage of colon cancer and the patient’s overall health.

'''Treatment options'''

'''Surgery'''

Surgery is the primary treatment for localized colon cancer. For stage III, adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (FOLFOX or CAPOX) is the standard of care.

'''Chemotherapy'''

Adjuvant chemotherapy is recommended for patients with stage III and high-risk stage II. Treatment is usually given for 3 to 6 months, depending on the specific regimen and risk of recurrence.

'''Targeted Therapy'''

Patients with metastatic colorectal cancer may receive EGFR-directed therapies (if they do not have KRAS/NRAS mutations) or VEGF, as well as BRAF inhibitors for patients with the BRAF V600E mutation.

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== 3. After treatment: follow-up, rehabilitation and survival ==

Monitoring- Intensive care unit, regular check-ups with physical examinations

Periodic imaging tests (ultrasound, CT or MRI) to monitor for recurrence.

Rehabilitation- Physical therapy to recover from surgery.

'''Psychosocial support:''' counseling and support groups for emotional well-being.

'''Long-term care for survivors:''' monitoring for late effects of treatment. Promoting health and lifestyle changes to improve overall well-being. Secondary prevention: screening for other malignancies and maintaining a healthy lifestyle.

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== 4. Palliative care (if applicable) ==

'''Palliative treatments:''' To relieve symptoms and improve quality of life in advanced cancer.

'''Pain management:''' Medications, nerve blocks.

'''Symptom control:''' Managing shortness of breath, pain, etc.

'''Hospice care:''' For end-of-life care when curative treatment is no longer an option.

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