After someone is diagnosed with colon cancer, doctors try to find out if it has spread and, if so, how far. This process is calledstaging. The stage of a cancer describes how much cancer is in the body. Helps determine the severity of cancer andthe best way to treat it. Doctors also use the stage of the cancer when discussing survival statistics.
The earliest stage of colon cancer is called stage 0 (a very early cancer) and then progresses from stages I (1) to IV (4). Generally, the lower the number, the less the cancer has spread. A higher number, such as B. Stage IV means that the cancer has spread further. And within a level, a previous letter means a lower level. Although each person's cancer experience is unique, cancers with similar stages tend to have a similar prognosis and are often treated in the same way.
How is the level determined?
The most widely used colorectal cancer staging system is the American Joint Committee on Cancer (AJCC).TNMSystem based on 3 key pieces of information:
- The extent (size) of thetfatigue(T):How far has the cancer grown into the colon or rectum wall? These layers include, from the inside out:
- The inner lining (mucous membrane), which is the layer where almost all colon cancers begin. This includes a thin layer of muscle (muscularis mucosa).
- The fibrous tissue beneath this muscle layer (submucosa)
- A thick layer of muscle (muscularis propria)
- The thin, outermost layers of connective tissue (subserosa and serosa) that cover most of the colon but not the rectum.
The system described below is the most recent AJCC system, effective January 2018. It uses thepathologisches Stadium(also called thesurgical stage), which is determined by examining the tissue removed during an operation. This is also referred to assurgical staging. This is probably more accurate thanclinical staging, which takes the results of a into accountphysical examination, biopsies and imaging tests, madeBeforeOperation.
The numbers or letters after T, N, and M provide more detail on each of these factors. Higher numbers mean the cancer is more advanced. Once an individual's T, N, and M categories have been determined, this information is combined in a process calledscenic groupassigned to a general level. For more information, seecancer staging.
Cancer staging can be complex, so ask your doctor to explain it to you in a way that you can understand.
Internship AJCC
Grouping by stages
stage description*
that is
N0
M0
The cancer is in its earliest stages. This stage is also known as carcinoma in situ or intramucosal carcinoma (Tis). It hasn't grown beyond the inner lining (mucous membrane) of the colon or rectum.
I
T1 or T2
N0
M0
The cancer has grown through the muscularis mucosa into the submucosa (T1) and may also have grown into the muscularis propria (T2). It has not spread to nearby lymph nodes (N0) or distant sites (M0).
IIA
T3
N0
M0
Cancer has grown into, but not through, the outermost layers of the colon or rectum (T3). It has not reached neighboring organs. It has not spread to nearby lymph nodes (N0) or distant sites (M0).
IIB
T4a
N0
M0
The cancer has grown through the colon or rectum wall but not into other nearby tissues or organs (T4a). It has not yet spread to nearby lymph nodes (N0) or distant sites (M0).
CII
T4b
N0
M0
The cancer has grown through the wall of the colon or rectum and has attached or invaded other nearby tissues or organs (T4b). It has not yet spread to nearby lymph nodes (N0) or distant sites (M0).
IIIA
T1 or T2
N1/N1c
M0
The cancer has grown through the mucosa into the submucosa (T1) and may also have grown into the muscularis propria (T2). It has spread to 1 to 3 neighboring lymph nodes (N1) or to areas of fat near the lymph nodes, but not to the lymph nodes themselves (N1c). It has not spread to distant locations (M0).
Ö
T1
N2a
M0
The cancer has grown through the mucosa into the submucosa (T1). It has spread to 4 to 6 adjacent lymph nodes (N2a). It has not spread to distant locations (M0).
IIIB
T3 or T4a
N1/N1c
M0
The cancer has grown to the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a), but has not reached nearby organs. It has spread to 1 to 3 adjacent lymph nodes (N1a or N1b) or to fatty tissue near the lymph nodes but not to the lymph nodes themselves (N1c). It has not spread to distant locations (M0).
Ö
T2 or T3
N2a
M0
The cancer has invaded the muscularis propria (T2) or the outermost layers of the colon or rectum (T3). It has spread to 4 to 6 adjacent lymph nodes (N2a). It has not spread to distant locations (M0).
Ö
T1 or T2
N2b
M0
The cancer has grown through the mucosa into the submucosa (T1) and may also have grown into the muscularis propria (T2). It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant locations (M0).
IIIC
T4a
N2a
M0
The cancer has grown through the colon or rectum wall (including the visceral peritoneum) but has not reached nearby organs (T4a). It has spread to 4 to 6 adjacent lymph nodes (N2a). It has not spread to distant locations (M0).
Ö
T3 or T4a
N2b
M0
The cancer has grown to the outermost layers of the colon or rectum (T3) or through the visceral peritoneum (T4a), but has not reached nearby organs. It has spread to 7 or more nearby lymph nodes (N2b). It has not spread to distant locations (M0).
Ö
T4b
N1 or N2
M0
The cancer has grown through the wall of the colon or rectum and has attached or invaded other nearby tissues or organs (T4b). It has spread to at least one nearby lymph node or to areas of fat near the lymph nodes (N1 or N2). It has not spread to distant locations (M0).
VAT
any t
any n
M1a
The cancer may or may not have grown through the wall of the colon or rectum (any T). It may or may not have spread to nearby lymph nodes. (Any N). It has spread to a distant organ (eg, liver or lungs) or set of lymph nodes, but not to distant portions of the peritoneum (the lining of the abdominal cavity) (M1a).
IVB
any t
any n
M1b
The cancer may or may not have grown through the wall of the colon or rectum (any T). It may or may not have spread to nearby lymph nodes (any N). It has spread to more than one distant organ (such as the liver or lungs) or a distant group of lymph nodes, but not to distant parts of the peritoneum (the lining of the abdomen) (M1b).
CIV
any t
any n
M1c
The cancer may or may not have grown through the wall of the colon or rectum (any T). It may or may not have spread to nearby lymph nodes (any N). It has spread to distant parts of the peritoneum (the lining of the abdominal cavity) and may or may not have spread to distant organs or lymph nodes (M1c).
FAQs
What are the stages of colorectal cancer? ›
The earliest stage colorectal cancers are called stage 0 (a very early cancer), and then range from stages I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. And within a stage, an earlier letter means a lower stage.
What are the 4 staging classifications of cancer? ›Localized—Cancer is limited to the place where it started, with no sign that it has spread. Regional—Cancer has spread to nearby lymph nodes, tissues, or organs. Distant—Cancer has spread to distant parts of the body. Unknown—There is not enough information to figure out the stage.
What is Stage 4 colorectal cancer? ›Stage IV colon cancers have spread from the colon to distant organs and tissues. Colon cancer most often spreads to the liver, but it can also spread to other places like the lungs, brain, peritoneum (the lining of the abdominal cavity), or to distant lymph nodes.
What is Stage 3 colorectal cancer? ›Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or (2) cancer has spread through the mucosa of the colon and/or rectum wall to the submucosa.
Can you survive stage 3 colorectal cancer? ›Stage 3. Almost 70 out of 100 people (almost 70%) with stage 3 bowel cancer (also called Dukes' C) will survive their cancer for 5 years or more after they're diagnosed.
Can you survive stage 4 colorectal cancer? ›Stage 4 colon cancer is the most serious and highest stage. The 5-year survival rate for stage 4 colon cancer is just under 15%. This means that about 15% of people with a diagnosis of stage 4 colon cancer will be alive in 5 years.
What is the difference between stage 1 2 3 and 4 cancer? ›Stage I: The cancer is localized to a small area and hasn't spread to lymph nodes or other tissues. Stage II: The cancer has grown, but it hasn't spread. Stage III: The cancer has grown larger and has possibly spread to lymph nodes or other tissues. Stage IV: The cancer has spread to other organs or areas of your body.
How do you determine cancer staging? ›Depending on where the cancer is located, a physical exam may give some idea as to how much cancer there is. Imaging tests like x-rays, CT scans, MRIs, ultrasound, and PET scans may also give information about how much and where cancer is in the body. Endoscopy exams are sometimes used to look for cancer.
What is the difference between Level 4 and Stage 4 cancer? ›Thus, a Level IV melanoma means a melanoma tha has invaded through a few of the skin layers, but if it is less than 1mm thick, it is only considered to be Stage I disease. But a Stage IV melanoma means the melanoma has spread throughout the body, and usually has very poor prognosis.
What is the average life expectancy of stage 4 colon cancer? ›Metastases can occur in any organ. Treatment of stage IV colon cancer is mostly palliative and its median survival is reported to be approximately 9 months with best supportive care.
Can stage 4 colorectal cancer go into remission? ›
“Stage 4 colon cancer isn't always terminal,” Gupta says. “A proportion of patients, especially those with limited liver disease, do very well and can be potentially cured.”
What is the survival rate of colorectal cancer stage 4? ›Stage 4 colon cancer survival rate
The average five-year survival rate for metastatic colon cancer is 72 percent for regional and 14 percent for distant cancer, according to the American Cancer Society.
If the cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year survival rate is 72%. If colon cancer has spread to distant parts of the body, the 5-year survival rate is 14%.
What is Stage 2 colorectal cancer? ›Stage II colorectal cancer. In stage IIA, cancer has spread through the muscle layer of the colon/rectum wall to the serosa. In stage IIB, cancer has spread through the serosa of the colon/rectum wall to the visceral peritoneum (tissue that lines the organs in the abdomen).
How much chemo is needed for stage 3 colon cancer? ›In patients with stage III colon cancer, adjuvant chemotherapy with a fluoropyrimidine combined with oxaliplatin reduces the risk of recurrence and mortality, with a treatment duration that may be shortened from 6 to 3 months in certain situations allowing to limit toxicities, especially cumulative sensitive neuropathy ...
What stage of colon cancer is not curable? ›This is referred to as metastatic (stage IV) colorectal cancer. Cure is not possible for most patients with metastatic colorectal cancer, although some patients who have limited involvement of distant organs (particularly restricted to the liver and/or lung) can be cured with surgery.
How long is chemo for colon cancer stage 3? ›Chemotherapy. Chemotherapy is usually given after surgery for stage 3 colon cancer to reduce the risk of recurrence. Chemotherapy can be started 4 to 8 weeks after surgery and is usually given for 6 months.
What is the life expectancy of someone with colorectal cancer? ›...
5-year relative survival rates for colon cancer.
| SEER stage | 5-year relative survival rate |
|---|---|
| Localized | 91% |
| Regional | 72% |
| Distant | 14% |
| All SEER stages combined | 64% |
If the colon cancer has spread too far for surgery to be effective, chemotherapy is the primary treatment option. Most people with stage 4 colon cancer will receive chemotherapy or specific targeted therapies to help control the cancer progression or symptoms.
Does colon cancer spread fast? ›In most cases, colon and rectal cancers grow slowly over many years. Most of those cancers start as a growth called a polyp.
What causes death in colon cancer patients? ›
If your loved one is dying from colon cancer, they most likely have diffuse metastases . That means their cancer has spread from the colon to other organs and lymph nodes. Metastatic cancer often causes pain in the location where cancer has spread.
Is Stage 3 cancer always fatal? ›A cancer diagnosis is a life-changing event. This is especially true if you're diagnosed with later-stage cancer. But stage 3 cancer isn't a death sentence. Survival rates are improving, and researchers are continually discovering and testing new targeted drugs and immunotherapies.
What stage does cancer spread to lymph nodes? ›stage 3 – the cancer is larger and may have spread to the surrounding tissues and/or the lymph nodes (or "glands", part of the immune system)
Is Stage 4 cancer worse then Stage 1? ›Cancer is typically labeled in stages from I to IV, with IV being the most serious. Those broad groups are based on a much more detailed system that includes specific information about the tumor and how it affects the rest of your body.
Is stage or grade more important in cancer? ›Doctors can't be certain exactly how the cells will behave. But the grade is a useful indicator. Doctors sometimes look at the cancer grade to help stage the cancer. The stage of a cancer describes how big the cancer is and whether it has spread or not.
What stage of cancer is chemotherapy used for? ›Usually, chemotherapy may be used for all stages in most cancer types. Chemotherapy is a type of medicine or combination of medications that is used to treat or kill cancer cells. Adjuvant therapy: Chemotherapy may be used after surgery to reduce the risk of cancer recurrence (coming back).
What do the letters mean in cancer staging? ›Doctors and researchers all use what is known as TNM classification. The abbreviation “TNM” stands for tumor (T), nodes (N), and metastases (M). “Nodes” indicates whether or not the tumor has spread into neighboring (regional) lymph nodes.
Does Stage 4 mean metastasized? ›Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV (4) cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
Is Stage 4 cancer always terminal? ›Is stage 4 cancer always terminal? Stage 4 cancer is not always terminal. It is usually advanced and requires more aggressive treatment. Terminal cancer refers to cancer that is not curable and eventually results in death.
Can you survive cancer stage 4? ›Although the overall prognosis may be poor based on cases with previous patients and older treatments, many patients with stage 4 cancer can live for years. A few factors to keep in mind: Many treatments are available to help fight cancer. Your body's response to treatment may differ from that of others.
What is the best medication for metastatic colorectal cancer? ›
- Alymsys (Bevacizumab)
- Avastin (Bevacizumab)
- Bevacizumab.
- Camptosar (Irinotecan Hydrochloride)
- Capecitabine.
- Cetuximab.
- Cyramza (Ramucirumab)
- Eloxatin (Oxaliplatin)
Using these data, the number needed to treat (NNT) in order to have one more person alive at both 6 months and 12 months is 6 [95% CI 5 to 10 at 6 months, and 4 to 11 at 12 months]. Median survival is estimated to be 8.0 months in the control group and 11.7 months in the chemotherapy group, a difference of 3.7 months.
How long is chemotherapy for colon cancer stage 4? ›Adjuvant or neoadjuvant chemo is often given for a total of 3 to 6 months, depending on the drugs used. The length of treatment for advanced colorectal cancer depends on how well it is working and what side effects you have.
How quickly does colorectal cancer progress? ›Colon cancer, or cancer that begins in the lower part of the digestive tract, usually forms from a collection of benign (noncancerous) cells called an adenomatous polyp. Most of these polyps will not become malignant (cancerous), but some can slowly turn into cancer over the course of about 10-15 years.
At what stage is colon cancer terminal? ›End-stage is when the cancer is no longer considered curable. Thus, end-stage cancer is stage IV cancer, but some people are fortunate enough to survive stage IV with modern treatments. As treatments continue to improve, more and more people will see multi-year survival after stage IV colon cancer.
What are the symptoms of stage 1 colorectal cancer? ›- A persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool.
- Rectal bleeding or blood in your stool.
- Persistent abdominal discomfort, such as cramps, gas or pain.
- A feeling that your bowel doesn't empty completely.
- Weakness or fatigue.