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- Colon Cancer
- Colon Cancer Stages
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A cancer’s stage refers to how large the primary tumor is and how far the cancer has spread in the patient’s body. Knowing the stage helps the care team understand the disease and develop an appropriate treatment plan. It also impacts the patient’s prognosis, or chance for a successful treatment.
TNM stages
The TNM staging system is used for most cancers.
TNM staging describes cancer based on three main factors:
- The size of the primary tumor (T) and whether it has invaded nearby tissues.
- The cancer’s spread to nearby lymph nodes (N).
- Whether the cancer has metastasized (M), or spread, to distant parts of the body.
Each TNM factor is assigned a number that reflects the extent of the cancer. Tumors (T) are scored between 1-4, nodes (N) 1-3, and metastasis (M) 0-1.
After all diagnostic and staging procedures are performed, your doctor should know the TNM stage of your cancer and be able to explain how this stage impacts your treatment and prognosis.
0 to IV stages
Often, TNM staging can be simplified into stages four stages (I-IV). For some cancers, there is also a stage 0. Larger numbers mean the cancer is more advanced and is generally more difficult to treat.
- Stage 0 reflects the presence of abnormal cells that have not spread to tissue that is immediately nearby. Stage 0 is considered precancerous, though it could become cancer in the future. This stage is also called “in-situ,” which means “in its original place.” Not all cancers have a stage 0.
- Stage I cancers are typically small and confined to the area where they began.
- Stage II and Stage III cancers have spread to nearby tissue and/or lymph nodes.
- Stage IV cancer has spread to distant areas of the body. This is also called metastatic cancer. Stage IV cancer often cannot be cured, but frequently can be managed like a chronic disease.
Colon cancer 0-IV stages
Source: National Cancer Institute
Stage 0 (Carcinoma in Situ)
In stage 0 colon cancer, abnormal cells are found in the mucosa (innermost layer) of the colon wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I colon cancer
In stage I colon cancer, cancer has formed in the mucosa (innermost layer) of the colon wall and has spread to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall.
Stage II colon cancer
Stage II colon cancer is divided into stages IIA, IIB, and IIC.
- Stage IIA: Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall.
- Stage IIB: Cancer has spread through the serosa (outermost layer) of the colon wall to the tissue that lines the organs in the abdomen (visceral peritoneum).
- Stage IIC: Cancer has spread through the serosa (outermost layer) of the colon wall to nearby organs.
Stage III colon cancer
Stage III colon cancer is divided into stages IIIA, IIIB, and IIIC.
In stage IIIA, cancer has spread:
- through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall. Cancer has spread to one to three nearby lymph nodes, or cancer cells have formed in tissue near the lymph nodes; or
- through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa). Cancer has spread to four to six nearby lymph nodes.
In stage IIIB, cancer has spread:
- through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to one to three nearby lymph nodes, or cancer cells have formed in tissue near the lymph nodes; or
- to the muscle layer or to the serosa (outermost layer) of the colon wall. Cancer has spread to four to six nearby lymph nodes; or
- through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall. Cancer has spread to seven or more nearby lymph nodes.
In stage IIIC, cancer has spread:
- through the serosa (outermost layer) of the colon wall to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to four to six nearby lymph nodes; or
- through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to seven or more nearby lymph nodes; or
- through the serosa (outermost layer) of the colon wall to nearby organs. Cancer has spread to one or more nearby lymph nodes, or cancer cells have formed in tissue near the lymph nodes.
Stage IV colon cancer
Stage IV colon cancer is divided into stages IVA, IVB, and IVC.
- Stage IVA: Cancer has spread to one area or organ that is not near the colon, such as the liver, lung, ovary, or a distant lymph node.
- Stage IVB: Cancer has spread to more than one area or organ that is not near the colon, such as the liver, lung, ovary, or a distant lymph node.
- Stage IVC: Cancer has spread to the tissue that lines the wall of the abdomen and may have spread to other areas or organs.
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