Colorectal Cancer Treatment by Stage
Stage O colorectal cancer is found only in the innermost lining of the colon. Treatment usually involves one of the following:
Polypectomy or local excision to remove the tumor and a small Colo amount of surrounding tissue, or
More extensive surgery (resection) to remove larger colon cancers. This may require a procedure called an anastomosis to remove the diseased part of the colon and reattach the healthy tissue to maintain bowel function.
Stage I Colorectal Cancer
Stage I tumors have spread beyond the inner lining of the colon to the second and third layers and involves the inside wall of the colon. The cancer has not spread to the outer wall of the colon or outside the colon.
Standard treatment involves surgery to remove the cancer and a small aount of tissue around the tumor. Additional treatments are not usually needed.
Aggressive surgery to remove all of the cancer offers a great potential for cure. The five-year survival rate for stage 1 colorectal cancer is 93% according to the American Cancer Society.
Stage II Colorectal Cancer
Stage II colorectal cancers are larger and setend through the muscular wall of the colon, but there is no cancer in the lymp nodes (small structures that are found throughout the body that produce and store cells that fight infection).
Standard treatment is surgical removal of the cancer and an area surrounding the cancer: Chemotherapy may also be given as a precaution against cancer recurrence. This is usually restricted to persons with high-risk disease, as the advantages of chemotherapy in this stage of colon cancer are minimal. An oncologist should help in making the decision as to whether chemotherapy is necessary for stage II colon cancers. The five-year survival rate for stage II colon cancer is 78%.
Stage III Colorectal Cancer
Stage III colorectal cancers have spread outside the colon to one or more lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Tumors within the colon wall, which also involve the lymph nodes are classified as stage IIIA, while tumors that have grown through the colon wall and have spread to one to four lymph nodes are classified as stage IIIB cancers. Those tumors, which have spread to more than four lymph nodes are classified as stage IIIC colon cancers.
- Surgery to remove the tumor and all involved lymph nodes if possible.
- After surgery, the patient will receive chemotherapy with 5-FU, leucovorin and oxaliplatin, capecitabine with oxaliplatin or capecitabine alone.
- Radiation may be needed if the tumor is large and invading the tissue surrounding the colon.
The five-year survival rate for stage III colon cancer is about 64%. Patients with one to four positive lymph nodes have a higher survival rate than people with ore than five positive lymph nodes.
Stage IV Colorectal Cancer
Stage IV colorectal cancers have spread outside the colon to other parts of the body, such as the liver or the lungs. The tumor can be any size and may or may not include affected lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).
Treatment may include:
- Removal of the cancer surgically or another surgical procedure to bypass the colon cancer and hook up healthy colon (an anatomises).
- Surgery to remove parts of other organs such as the liver, lungs, and ovaries, where the cancer may have spread.
- Chemotherapy to relieve symptoms and improve survival.
- Erbitux, Avastin, or Vectibix in combination with standard chemotherapy, depending upon tumor characteristics.
- Clinical trials of new chemotherapy regimens, or immunological therapy.
- Radiation to relieve symptoms.
The five-year survival rate for stage IV colon cancer is nearly 8%.
Recurrent Colorectal Cancer
Recurrent colorectal cancer is cancer that returns after surgical treatment, and with or without adjuvant chemotherapy. The recurrence may be local or near the area of the initial cancer, or the cancer may return in distant organs.
The liver is involved in up to 2/3 of patients who die from colorectal cancer.
Recurrence is most likely in patients with more advanced colorectal cancer, at the time or original diagnosis.
Treatment may involve:
- Surgery to remove the recurrences. This may lengthen life span and in some cases, this is curative when give with chemotherapy.
- If the metastases cant be removed, chemotherapy is the main treatment.
- Clinical trials are another option.