Stages of Colon Cancer

Once cancer of the colon is found (diagnosed), more tests will be done to find out if cancer cells have spread to other parts of the body (staging). In order to stage colon cancer, a surgical procedure will need to be performed. Knowing the stage of the disease will assist the doctor in effectively planning further treatment. The following stages are used for cancer of the colon:

Stage 0 or carcinoma in situ
Stage 0 cancer of the colon is very early cancer. The cancer is found only in the innermost lining of the colon. Treatment may be one of the following:

Local excision or simple polypectomy to remove all the cancer.
Bowel resection.

Stage I
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, but 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
Cancer has spread outside the colon to nearby tissue, but it has not gone into the lymph nodes. (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 one of the following:

Treatment is usually surgery (bowel resection) to remove the cancer.
Clinical trials of chemotherapy, radiation therapy, or biological therapy following surgery.
If the tumor has spread to nearby tissue, a patient may also receive chemotherapy and/or radiation therapy following surgery.

Stage III
Cancer has spread to the 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 may be one of the following:

Treatment is usually surgery (bowel resection) to remove the cancer followed by chemotherapy.
Clinical trials of chemotherapy, radiation therapy, and/or biological therapy following surgery.

Stage IV
Cancer has spread 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.
Chemotherapy.
Clinical trials of chemotherapy or biological therapy.

Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may recur in the colon or in another part of the body. Recurrent cancer of the colon is often found in the liver and/or lungs.

Treatment
If the cancer has come back (recurred) 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.

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