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Colon cancer: Symptoms | Staging | Definition | Treatments

Staging of colon cancer:

Treatment depends partly on the "stage" of the cancer. This means how far the tumor has spread through the layers of the intestine, from the innermost lining to outside the intestinal wall and beyond:

  • Stage 0: Very early cancer on the innermost layer (more accurately considered a precursor to cancer)
  • Stage I: Tumor in the inner layers of the colon
  • Stage II: Tumor has spread through the muscle wall of the colon
  • Stage III: Tumor that has spread to the lymph nodes
  • Stage IV: Tumor that has spread to distant organs

Stage 0 colon cancer may be treated with a local exicision of the lesion, often via a colonoscopy. In some cases, more extensive surgery may be needed (see stages I-III). For stages I, II, and III cancer, removal of a segment of colon containing the tumor and reattachment of the colon is necessary. This procedure only rarely requires a colostomy.

Almost all patients with stage III colon cancer, after surgery, should receive chemotherapy (adjuvant chemotherapy) with a drug known as 5-fluorouracil given for approximately 8 months. This drug has been shown to increase the chance of being cured. There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery and patients should discuss this with their oncologist.

Chemotherapy is also used for patients with stage IV disease in order to shrink the tumor, lengthen life, and improve quality of life. Irinotecan and 5-fluorouracil are the two most commonly used drugs, given either individually or in combination. A new drug, oxaliplatin, is also useful in these patients, but has not yet been approved by the FDA.

Radiation therapy is occasionally used in patients with colon cancer, but this is relatively uncommon.

illustration

Stages of colorectal cancer - The staging of a carcinoma has to do with the size of the tumor, and the degree to which it has penetrated. When the tumor is small and has not penetrated the mucosal layer, it is said to be stage I cancer. Stage II tumors are into the muscle wall, and stage III involves nearby lymph nodes. The rare stage IV cancer has spread (metastasized) to remote organs.

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