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lifestyle and philosophy of treatment as well as your age, general health and other medical conditions will be taken into consideration along with the tumor markers. In addition, we will work closely with your family physician to determine whether a less aggressive or more aggressive approach needs to be utilized to assure the best result.

If you would like to read more about colorectal cancer, we have provided several links at the right to authoritative sources about the disease, its treatments and support. We want you to know that the doctors in this office and our excellent Oncology staff will be available to you at all times, supportive in all aspects of your care and we encourage your questions and input.

© Lynn Herbert Ratner MD

Colorectal Cancer Basics disclaimer

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The journey for patients who have just been diagnosed with colorectal cancer (sometimes just called colon cancer) can be very daunting and frightening, but there are many pathways which the doctors in our practice use to make that journey easier for you to follow and with better outcomes. After the diagnosis is made, usually by colonoscopy and a biopsy of the tumor, it is most important for us to stage the disease so that we can accurately classify the type of tumor and whether or not it has spread to other areas.

In a simplified fashion, what we do is to look at all aspects of the body with particular attention to areas where the tumor may spread. These studies include blood tests which we conduct in our office, as well as imaging studies such as CT scans or other x-rays which the radiologist will perform at another location. In addition, we interact closely with other medical specialists including surgeons, radiation therapists; and, whenever needed, your own primary care physician or internist.

It is best if we stage the tumor before or very soon after definitive surgery is performed using the so-called TNM staging. (T refers to the size of the tumor, N refers to the number of lymph nodes involved, if any, and M refers to metastases or spread of the tumor to other locations).

The physician you work with in our office will examine several characteristics of the tumor to determine how best to treat it including the size of the tumor, the grade of the tumor, and whether or not there are any specific molecular targets which would make the tumor more responsive to the newer treatments. These newer treatments are called targeted therapies or immune modulated therapies, which are specially designed for each specific tumor type.

Once accurate staging has been performed, a treatment program will be formulated in consultation with you and your family if you wish. Surgery and radiation therapy may be indicated as well as systemic therapy such as chemotherapy. It is important to know that every chemotherapy treatment is different when it comes to colorectal cancer, and there are various stages at which we use different combinations of these drugs. In addition, there are targeted personalized therapies which can be used, depending on the molecular and genetic makeup of the tumor.

We will make every effort to ascertain what the best program is for you, using national guidelines as our template. But we do not use a cookie-cutter approach. Your personal

Valuable Colon Cancer Resources

The National Cancer Institute information for patients about colorectal cancer

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The National Library of Medicine
X-Plain teaching module for patients about colorectal cancer

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The American Cancer Society information for patients about colorectal cancer

Lynn H Ratner MD
Paul A C Greenberg MD

112 East 83rd Street
New York City, NY 10028
tel: 1-212-396-0400 fax: 1-212-396-9800

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Doctors Ratner and Greenberg

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