Diagnostic tests show the stage of colon cancer. The stage of a cancer tells how big the tumor is, how deep it is and if it has spread to other parts of the body. Treatment is determined by the stage of the cancer. The stage also gives information about the overall outlook for the patient. The lower the stage, the better the outlook.
Stage 0 – The cancer is found only in the innermost lining of the colon. This also is called “carcinoma in situ.”
Stage I – The cancer has spread beyond the innermost lining of the colon and into the second and third layers of the colon wall, but it has not spread to the outer wall of the colon. Stage I colon cancer is sometimes called “Dukes A Colon Cancer.”
Stage II – The cancer has spread beyond the colon and into nearby tissue, but it has not reached the lymph nodes. (Lymph nodes are rounded masses of lymphoid tissue found throughout the body – they help fight infection and disease). Stage II colon cancer is sometimes called “Dukes B Colon Cancer.”
Stage III – Cancer has spread to nearby lymph nodes but not to other parts of the body. Stage III colon cancer is sometimes called “Dukes C Colon Cancer.”
Stage IV – Cancer has spread to other parts of the body, such as the liver or lungs. Stage IV colon cancer is sometimes called “Dukes D Colon Cancer.”
Recurrent Colon Cancer – Cancer is called recurrent when it comes back to the same place or in another part of the body after a period of time. The recurrent cancer may not have similar or associated symptoms.
Surgery – Surgical removal of the cancer is the most common treatment for all stages of colon cancer. Doctors use several types of operations to remove colon cancer:
- Local excision. When the cancer is in a very early stage, the doctor can remove it without making a cut or incision on the abdomen. The doctor will place a tube into the rectum and colon and remove the cancer through the tube.
- Resection. If the cancer is larger, the doctor will perform a colectomy. This means removing part of the colon where the cancer is located and part of the healthy tissue surrounding the cancer. The doctor may then do an anastomosis (sewing the healthy parts of the colon together). The doctor also will usually remove lymph nodes near the colon and examine them under a microscope to see if they contain cancer cells.
- Resection and colostomy. If the doctor is not able to sew the two ends of colon back together, an opening (stoma) is made on the outside of the body for bowel movements to pass through. This operation is called a colostomy. Colostomies are sometimes needed only until the lower colon has healed, and then the two parts of the colon can be rejoined. However, a colostomy is sometimes permanent.
Click here to learn about minimally invasive surgery for colon cancer.
Chemotherapy – Chemotherapy, medicine that kills cancer cells, can be taken in a pill form, or it may be given in the vein or muscle through a needle. However it is given, the medicine will reach the entire body and kill cancer cells throughout the body.
Radiation therapy – X-rays or other types of energy are used to kill cancer cells and to shrink tumors. Radiation is usually administered from outside the body using a machine (external radiation).
Biological therapy – This is now being studied in clinical trials for use in colon cancer treatment. Biological therapy uses substances to stimulate the body's own immune system to fight the cancer.
To make an appointment with a Washington University colorectal surgeon, please call (314) 454-7177.