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Colon Cancer Staging: What You Need to Know for Effective Treatment
By Raveena M Prakash
Colon cancer is the third most common cancer across the world. According to WHO, approximately 10% of all cancer cases are colon cancer, also known as colorectal cancer. This is the second leading cause of cancer deaths occurring worldwide. Understanding colon cancer staging is essential for the beginning of your cancer treatment and prognosis for a patient’s individual medical condition. The staging of cancer depends on factors such as the type of cancer, the patient’s age and gender, the tumor and location, and whether the cancer has spread to the body or not.
In this article, we’ll dive deeper into the colorectal cancer staging, its symptoms and treatment options, factors influencing cancer staging, and its prognosis and survival rate.
What is Colon Cancer?
Colon cancer, also known as colorectal cancer, develops in your colon, commonly known as the large intestine, a long tube that usually helps to carry digested food to the rectum and out of the body. This type of cancer often develops from certain polyps or some growths in the inner lining of the colon. When this cancer is not detected or treated on time, it may spread into other parts of the body. This is commonly called colon cancer metastasis.
The stages of Colon Cancer
Staging of colon cancer often helps to describe the extent of cancer, the size of the tumor, whether it has spread, and from where the tumor first started the spread in the body. There are mainly five stages of colorectal cancer. Three of the four stages have three sub-stages.
The colorectal cancer staging system includes the following:
Stage 0 Colorectal cancer:
Stage 0 is the initial stage of colorectal cancer, this is also known as carcinoma in situ or (intramucosal carcinoma). In this stage, the cancer cells are often found in the rectum or colon’s inner lining.
- In this stage, the majority of abnormal cells are found in the innermost layer, commonly known as the mucosa, which lines the colon or rectum, but these cells have not become cancerous cells.
Stage I colorectal cancer:
In stage I, the cancerous cells are found in the deeper layers of colon or rectum wall. But, at this stage, the cancer hasn’t spread beyond the rectum wall.
- At stage I, the cancer cells are found in the inner layers of the lining of the colon or rectum, and they have grown into the second layer of tissue, also called the submucosa.
- In this stage, the cancer might have spread to a nearby layer, also known as the muscularis propria, but it has not reached nearby the lymph nodes.
Stage II colorectal cancer:
In stage II, the cancer has not spread into the nodes of lymph, but there may have been some spread through and beyond the wall of the colon or rectum. Sometimes these cancers can spread into nearby tissues or organs.
Stage II cancer has three sub-types, these may include:
Stage II A: In this stage, the cancer spreads through the layers of the colon or rectum wall, and it has often reached the outermost layer, but not farther.
Stage II B: In this stage, the cancer has grown across the outermost layer of the colon or rectum wall, but it hasn’t spread to any nearby tissues or organs.
Stage II C: The cancer has spread across the outermost layer of the colon or rectum wall and has grown into nearby tissues or organs, but it hasn’t spread to lymph nodes or distant organs.
Stage III colorectal cancer:
In stage III, the cancer cells have often spread to one or more nearby lymph nodes. However, they have not grown beyond the lymph nodes and colon or rectum wall to other parts of the body.
Stage III cancer has three sub-types, these may include:
Stage III A: In this stage, the cancer has spread through the first two layers of the rectum wall, such as the mucosa and submucosa. This might also reach the third layer, mostly known as the muscularis propria. The cancer spread has also reached one or three nearby lymph nodes, or cancer cells are found near the lymph nodes.
- The cancer has spread through the first two layers of the colon or rectum wall, and this has reached approximately four to six nearby lymph nodes.
Stage III B: In this stage, the cancer has reached the outermost layer, also commonly known as the serosa, of the colon or rectum wall. The cancer might have spread through the tissue that lines the abdominal organs, such as the visceral peritoneum, but it has not yet reached the nearby organs. The tumor might have been found in one or three lymph nodes, or the cancer cells are found near the lymph nodes.
- The cancer has grown into the muscle layer or the outermost layer of the colon or rectum wall. This cancer might have reached four to six nearby lymph nodes.
- The cancer has grown through the first two layers of the colon or rectum wall. The cancer might have reached the muscle layer. The cancer spread is found in seven or more lymph nodes.
Stage III C: In this stage, the cancer has grown across the colon or rectum wall. This cancer has spread to the tissue that lines the abdominal organs, but it has not yet spread to nearby organs. The cancer has been found in four to six nearby lymph nodes.
- The cancer has grown beyond the colon or rectum wall. This has spread through the tissue that lines the abdominal organs. The spread has been found in seven or more nearby lymph nodes.
- The cancer has spread beyond the wall of the colon or rectum has grown into nearby organs or tissues. The cancer is often found in at least one nearby node, or cancer cells are found near the lymph nodes.
Stage IV colorectal cancer:
The stage IV cancer also known as metastatic colon cancer. This cancer has spread beyond the colon or rectum to other areas of the body, including tissues and organs. These are classified as:
- Stage IV A: In this stage, the cancer has often reached one area or organ that is not near the colon or rectum, such as the liver, lung, ovary, or any distant lymph node.
- Stage IV B: In this stage, the cancer has reached more than one area or organ that is not near the colon or rectum.
- Stage IV C: The cancer has spread to many far and distant parts of the tissue that lines the abdominal wall. The cancer might have reached other areas or organs.
Factors influencing the Colon cancer stage
Here are some significant factors that influence colon cancer, such as lifestyle choices, which are also considered risk factors of this type of cancer.
These may include:
- Habit of smoking
- Excessive alcohol use
- Obesity and overweight
- Diet that uses red meat and processed meat
- Not practicing exercise
Prognosis and survival rates of colon cancer
Colorectal cancer survival rates showcase that patients with this type of cancer are alive five years or more after the diagnosis. When compared to other people who don’t have this particular cancer type. The NCISP, further based on the survival rates of cancer that has affected the colon, mentions how far the spread has gone.
| Colon cancer stage | Extent of cancer spread | Five year survival rate |
|---|---|---|
| Localized | The cancer hasn’t spread outside the primary site | 90.9% |
| Regional | The cancer has spread from the area of origin to nearby lymph glands or nodes | 73.4% |
| Distant | The cancer has spread to distant body parts away from the colon region such as lungs. | 15.6% |
Colon cancer treatment by stage
The staging often refers to how much the cancer is localized or spread outside its original area. For this type of cancer, surgery is the first treatment for localized cancer. Chemotherapy is another treatment option for this cancer.
After your cancer diagnosis, the healthcare providers work with the patients to develop a healthy treatment plan depending on the stage.
Stage 0: For this stage, surgery is the primary line of treatment, the only treatment that is needed. It often removes the colon polyp, which is also known as a group of cells. This is the area of cancer in the colon, in a surgical procedure known as polypectomy. In some cases, the oncologist might perform a surgical procedure known as a colonoscopy.
If the cancer is too large to get removed, the surgical oncologist might perform a partial colectomy; this removes the part of the colon. This process removes the cancerous section of the colon and nearby lymph glands or nodes. In some cases, they might join healthy parts of the colon after removing the cancer in a procedure called anastomosis.
Stage I: If a polyp is discovered in a patient, this will be removed during a colonoscopy. In some cases, the surgeries might be performed when cancer cells are located at the edge of the polyp.
- The cancer appears to be high-grade, such that it might grow and spread more quickly.
- When the polyp can’t be fully removed from the body.
- The polyp has to be removed in several pieces (to remove other cancer cells that might be located in the margins of the tissue).
- Surgery for stage I cancer involves a surgical procedure known as partial colectomy; this removes the part of the colon.
Stage II: In stage II, surgery is the first-line treatment. It might include partial colectomy and surgery used to remove nearby lymph nodes. Chemotherapy is also used after the surgery.
Stage III: The most common treatment for Stage III cancer includes a partial colectomy and removal of lymph nodes along with adjuvant chemotherapy.
- In some cases, radiation therapy is performed with chemotherapy if the cancer cannot be completely removed from the body.
Stage IV: Stage IV cancer, also known as metastatic cancer. In this stage, the tumor might have spread from the colon to distant organs and tissues, including the brain, lymph nodes, lining of the abdominal cavity, the liver, and the lungs.
- The treatments may include surgery, chemotherapy, targeted therapy, and radiation therapy.
Consult Today
Understanding the stages in colorectal cancer is crucial for planning effective treatment options and improving the results. Early detection through regular cancer screening tests and scans is one of the effective ways to ensure timely intervention and an increased chance of survival in the majority of people.
If you or any loved ones of yours have been diagnosed with this type of cancer, visit Oncare Cancer Center’s website now and book an appointment today!
Call us to get a more personalized consultation from our experienced cancer specialist and get an estimated cost of treatment options today!
Frequently Asked Questions (FAQs)
Prevention of colon cancer is not easy. You can reduce the risk of developing colon cancer by managing or reducing the risk factors.
- Stop smoking and avoid tobacco use
- Avoid excessive alcohol consumption
- Maintain a healthy weight
- Eat healthy, balanced diet
Surgery is the most common treatment option considered to treat colon cancer in people. There are some surgeries and procedures used for the treatment and cure of this cancer.
- Polypectomy
- Partial colectomy
- Surgical resection with colostomy
- radiofrequency ablation
There are some other cancer treatments might be performed to treat these cancers, it may include:
- Chemotherapy
- Targeted therapy
There are some screening tests usually performed to diagnose colon cancer in suspected cancer patients.
These may include:
- Complete blood count test (CBC)
- CT Scan
- MRI Scan
- PET Scan
- Ultrasound
- Biopsy
- X-rays
- Carcinoembryonic antigen assay (CEA)
- Comprehensive metabolic panel
Lifestyle choices that are major risk factors for increasing colon cancer.
These may include:
- Stop smoking.
- Excessive alcohol consumption
- Obesity and overweight
- Intake of red meat and processed meat
- Low physical activity