What does TNM mean?

TNM is a classification system for cancer diseases, which tries to describe the tumor and its spread as accurately as possible with its three letters. The T describes the tumor and its local spread.Since tumors also spread through the lymphatic system and blood in the body, the sole description of the tumor is not sufficient. Therefore, the N is used to describe the infestation of the lymph nodes of tumor tissue. The M describes how the tumor has spread to other organs, i.e. its metastases. By weighing up these three factors, the tumor can then be assigned to a stage, according to which further therapy is then determined.

What does neoadjuvant therapy mean?

Neoadjuvant therapy is a therapy that is applied before tumors are operated on. This can be chemotherapy or radiation, which is intended to reduce the size of the tumor before surgery to improve the initial situation for the operation. Ideally, this can achieve that inoperable tumors can be operated on after all, or that the operation itself must be less extensive.

Guidelines

In Germany, the German Cancer Society, the German Cancer Aid and the Association of the Scientific Medical Societies in Germany (AWMF) publish standardized guidelines that describe the recommended procedure for the diagnosis, therapy and follow-up treatment of cancer, including colorectal cancer, based on the latest studies. In addition to clear guidelines for physicians, the AMWF also publishes guidelines that are specifically aimed at patients and aim to explain the diagnostic and therapeutic route in an understandable way. The current guidelines are freely available on the AMWF website and are valid until June 2018.

Internationally, there are various professional societies which, like the AMWF, publish their own guidelines based on the latest scientific findings. Such societies are for example the European Society for Medical Oncology or the National Comprehensive Cancer Network. The follow-up treatment depends on the stage of the tumor.

In addition to taking a medical history, recording current symptoms and physical examination, some examination techniques are an integral part of rectal cancer aftercare. These include the determination of the tumor marker CEA, colonoscopy, ultrasound examination of the liver, X-ray examination of the thorax and computed tomography of the pelvis. Since the probability of developing a second tumor is highest in the first two years, follow-up examinations are particularly important during this period. In addition, the patient is recommended to take health-promoting measures, especially regular physical exercise and healthy nutrition, to promote health.