Gastrointestinal (GI) Oncology Program

Colon Cancer

Stages

If you are diagnosed with cancer of the colon, your doctor will order more tests to find out if the cancer cells have spread to other parts of the body. The process of determining whether and where the cancer has spread is called staging.

For colon cancer, staging often involves surgery. Knowing the stage of the disease will help the doctor plan further treatment. Cancer of the colon is classified in the following stages:

Stage 0 or carcinoma in situ: Carcinoma in situ is very early cancer. The cancer is found only in the innermost lining of the colon. Treatment will probably be surgery, either a local or simple polypectomy or a bowel resection. These procedures are described in the following section.

Stage I: At this stage, the cancer has spread beyond the innermost lining of the colon to the second and third layers and involves the inside wall of the colon. It has not spread to the outer wall of the colon or outside the colon. Stage I colon cancer is sometimes called Dukes' A colon cancer. Treatment is usually surgery (bowel resection) to remove the cancer and join the cut ends of the bowel.

Stage II: Stage II cancer has spread outside the colon to nearby tissue, but it has not gone into the lymph nodes or beyond. (Lymph nodes are small, bean-shaped structures that are found throughout the body. They produce and store cells that fight infection.) Stage II colon cancer is sometimes called Dukes' B colon cancer. Treatment may be either (1) surgery (bowel resection) to remove the cancer; (2) a clinical trial of chemotherapy, radiation therapy, or biological therapy following surgery; or, if the tumor has spread to nearby tissue, (3) chemotherapy and/or radiation therapy following surgery.

Stage III: Cancer has spread to nearby lymph nodes, but it has not spread to other parts of the body. Stage III colon cancer is sometimes called Dukes' C colon cancer. Treatment is usually either surgery (bowel resection) to remove the cancer or clinical trials of chemotherapy, radiation therapy, or biological therapy following surgery.

Stage IV: At this stage, the cancer has spread beyond the colon to other parts of the body. Stage IV colon cancer is sometimes called Dukes' D colon cancer. Treatment may be one of the following:

Surgery (bowel resection) to remove the cancer or to make the colon go around the cancer so that it can still work.
Surgery to remove parts of other organs such as the liver, lungs, and ovaries, where the cancer may have spread.
Radiation therapy to relieve symptoms.
Chemotherapy to relieve symptoms.
Clinical trials of chemotherapy or biological therapy.

Recurrent: Recurrent cancer is cancer that has come back (recurred) after it has been treated. It may come back in the colon or in another part of the body. Recurrent colon cancer is often found in the liver and/or lungs. If the cancer has come back in only one part of the body, treatment may consist of an operation to take out the cancer. If the cancer has spread to several parts of the body, a doctor may give a patient either chemotherapy or radiation therapy. The patient may also choose to participate in a clinical trial testing new chemotherapy drugs or biological therapy.

This page was last updated on: March 3, 2008.

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