http://www.antonbilchikmd.com | The optimal means of staging colon cancer are not found in the AJCC Staging Manual. Dr. Anton Bilchik’s preeminent position in the field of cancer treatment means he is an ideal source of information on colon cancer and all types of cancer.

1. Colon Cancer Staging Guidelines Not Yet Optimal
The American Joint Commission on Cancer periodically releases guidelines on cancer staging, or
the process of determining how far a cancer has spread. These guidelines are highly useful to
physicians and researchers, alike, but the guidelines from the seventh edition of the AJCC
Staging Manual (AJCC-7) do “not address all survival discrepancies for colon cancer” (Hari et
al., 2013), and physicians treating colon cancer should consider other prognostic factors before
deciding on a specific course of therapy for their patients.
How Staging Works
The AJCC assigns a Roman numeral from I to IV to a cancer, reflecting how far that cancer has
spread. The system is capable of showing more detail in the spread of cancer than four discrete
stages. There are substages, such as IIA, IIB, etc. The staging of a cancer plays a key role in
determining courses of treatment, so assigning a correct stage is crucial. The lowest Roman
numeral is for a localized cancer and the highest is for a metastasized cancer -- one that has
spread as far as it is possible to test.
Changes to Colon Cancer Staging: Comprehensive Enough?
The seventh edition of the AJCC Staging Manual includes major revisions to the staging of colon
cancer. To test the efficacy of these revised guidelines, a team of prominent cancer physicians,
including Dr. Anton Bilchik, “used a national cancer database to determine if these changes
improved prediction of survival” (Hari et al., 2013).
The database used was that maintained by the Surveillance, Epidemiology and End Results
Program. Queries were made to this database regarding the incidence of patients with
pathologically confirmed Stage I through Stage III colon cancer diagnosed in the ten-year spread
between 1998 and 2008. “Pathologically confirmed” indicates that sections of potentially
cancerous tissue have actually received a visual examination from a pathologist.
A total of 157,588 patients, or 68.9% of the total group queried, could be classified using AJCC6 and AJCC-7 staging, after all exclusion criteria were applied. However, no matter how many
lymph nodes were examined, this most recent staging of colon cancer by the AJCC does not
provide an all-encompassing picture of survival discrepancies, and the conclusion drawn by this
study was that “Consideration of other prognostic factors is critical for decisions about therapy,
particularly for patients with stage II CC” (Hari et al., 2013).
A great deal of detailed and useful information on issues related to colon cancer can be found on
the medical blog of Dr. Anton Bilchik, antonbilchikmd.com. Dr. Bilchik is one of the nation’s
leading cancer surgeons. Colorectal cancer is one of Dr. Bilchik’s specialties, and he has devoted
years of his storied career to studying and treating it. Colon cancer is truly a complex disease,
and it requires a physician to have a complex skill set in order to accurately diagnose and treat it.
Bio: Dr. Anton Bilchik is one of the nation’s leading cancer doctors. He is an expert on all stages
of colon cancer detection and treatment, as well as on cancer in general. He provides detailed,
useful information to patients and prospective patients on his detailed blog.

2. Summary: The optimal means of staging colon cancer are not found in the AJCC Staging
Manual. Dr. Anton Bilchik’s preeminent position in the field of cancer treatment means he is an
ideal source of information on colon cancer and all types of cancer.
Sources:
1. Hari, D.M., et al. (Aug. 2013) “AJCC Cancer Staging Manual 7th edition criteria for colon
cancer: do the complex modifications improve prognostic assessment?”: PubMed.gov.
2. Various Authors. (December 16, 2013) “Cancer Staging.” Wikipedia.org.
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Anton Bilchik