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Lindsey Zhang, M.D., Colon and Rectal Surgeon: The reason that surgery is often the first step in colon cancer is because we don't know the staging until we have the entire tumor out.

And then our great pathologists here at Mayo Clinic, they will look at it under the microscope and they'll tell me, this tumor has gotten this large and it's invaded this deep into the wall of the colon. And there are this many lymph nodes and, you know, sometimes they say there's no cancer in the lymph nodes or sometimes they'll say there is cancer in the lymph nodes, and that's what helps me determine the stage.

In rectal cancer you can stage.

So you use either MRI of the pelvis or ultrasound of the rectum to help understand how far has this tumor grown into the wall of the rectum and are there any lymph nodes that look enlarged or suspicious. And that gives us an idea of just how advanced the rectal tumor is.

We take every single patient's case here very individualized and we look at what matters to them, what their specifics are to their tumor, to their cancer, and we design a plan that's specific for them.

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