Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Colorectal Cancer
Colorectal cancer is the third leading cause of cancer and the second leading
cause of all cancer-related deaths in the United States. Each year
approximately 145,000 new cases of colorectal cancer are diagnosed in the
United States (105,000 new cases of colon cancer and 40,000 new cases of
rectal cancer). The lifetime chances of developing colorectal cancer is
approximately 5%. Combined, these two types of cancer cause 56,000 deaths
per year. The frequency of colon cancer is essentially the same among men
and women. Signs and symptoms associated with colorectal cancer include:

  • Rectal bleeding (overt or occult)
  • Change in bowel habits
  • Mucus per rectum
  • Abdominal pain
  • Weight loss

If detected early, colon and rectal cancer are curable by surgery. Long-term
survival correlates with the stage at diagnosis of the disease in colorectal
cancer. Progress has been made in understanding the basis for predisposition
and progression of colorectal cancer. Risk factors for colorectal cancer include:

  • Age
  • Diet rich in fat and cholesterol
  • Inflammatory bowel disease (ulcerative colitis)
  • Alcohol ingestion in rectal cancer
  • Genetic predisposition (hereditary polyposis and nonpolyposis

Hereditary nonpolyposis colorectal cancer (HNPCC) is the most common known
hereditary cause of colon cancer. HNPCC is hereditary and involves a mutation
in one of five different genes and is also known as Lynch Syndrome. About 1%
to 5% of colon cancers are attributed to HNPCC. A patient with HNPCC has up
to 80% chance of developing colon cancer during their lifetime. The mean age
for someone with HNPCC developing colorectal cancer is 44 years. Cancers
tend to be on the right (ascending) colon, are poorly differentiated and mucus
producing. Genetic testing and screening in these individuals with HNPCC for
colon cancer should be started as early as 20-22 years of age.

The vast majority of colorectal cancers are adenocarcinomas which arise from a
preexisting adenomatous polyp(s) that develop in the normal colon mucosa.
The progression sequence from adenoma to carcinoma is a well characterized
clinical and histopathological series of events. Convincing evidence of
increased early detection resulting in a reduced colorectal cancer mortality
supports the use of specific screening guidelines which include:

  • Colonoscopy
  • Flexible sigmoidoscopy
  • Barium enema
  • Fecal occult blood test
  • Carcinoembryonic antigen (CEA)
  • Digital rectal examination

Failure to adhere to the acceptable screening guidelines can result in a
significant delay in the diagnosis of colon and rectal cancer, depriving a patient
of a meaningful chance of cure and a better quality of life.

The overall 5 year survival rate from colon cancer is approximately 60%. the 5
year survival rate is different for each stage of the disease at the time of
diagnosis. Several classifications are utilized to stage colon cancer. The Dukes
and TNM System are the most widely used.

Dukes (modified) Classification

  • Stage A:   Carcinoma confined to the wall of the bowel
  • Stage B:   Carcinoma spread by direct continuity to perirectal or
tissue; no lymph node metastasis
  • Stage C:   Metastasis present in regional lymph nodes
  • Stage D:   Omental implant; peritoneal seeding; metastasis beyond the
confines of surgical resection

Tumor-Node-Metastasis (TNM) System

  • TNM  0:   Tis, N0, M0
  • TNM   I:    T1, N0, M0 & T2, N0, M0
  • TNM  II:    T3, N0, M0 & T4, N0, M0
  • TNM III:     Any T, N1, M0 & Any T, N2, M0
  • TNM IV:    Any T, Any N, M1

For Dukes stage A tumors involving only the mucosa, the 5 year survival rate
exceeds 90%; For Dukes stage B colon cancers, the 5 year survival rate is
greater than 70% and can get to be better than 80% if the tumor does not
penetrate the muscularis mucosa; For Dukes stage C with lymph nodes
involvement, the 5 year survival rate is usually less than 60%; and for
metastatic colon cancer, the 5 year survival rate is about 5%.

If you (or a loved one) are suffering from complications due to a failure to timely
diagnose, delayed diagnosis or misdiagnosis of  colon or rectal cancer, or the
recommended screening guidelines were not followed, let
Dr. Borten and the
Boston area medical malpractice attorneys at Gorovitz & Borten evaluate your
case. We can help you assert your rights and get the compensation you
Contact Information
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(when possible), please contact us by phone, fax or e-mail with your question or

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