Stages

If colorectal cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

Stages of Colorectal Cancer
Staging of Colorectal Cancer depends on three factors:
  • T — for Tumor: How far the tumor extends from the inner lining of the colon through the layers of its walls. 
  • N — for Nodes: Whether cancer cells are found in the lymph nodes draining the colon near the site of the cancer and how many nodes are affected. Lymph nodes are small, bean-shaped structures found throughout the body that filter substances in a fluid called lymph and help fight infection and disease. 
  • M — for Metastasis: Whether cancer has spread beyond the colon and its adjacent tissues to distant organs like the lungs or liver. 
Stages of Colorectal Cancer 
Colorectal Cancer starts in the cells lining the inside of your colon or rectum. As it grows, the cancer begins to push through into deeper levels of the intestine and can release cancer cells into the lymph system and blood stream.

Colon and Rectal Cancers have similar but not identical definitions of staging, as follows:


Stage 0 (Carcinoma in Situ)
  • Colorectal: In stage 0, the cancer is found in the innermost lining of the colon or rectum only. 
Stage I
  • Colon: In stage I, the cancer has spread beyond the innermost tissue layer of the colon wall to the middle layers. Stage I colon cancer is sometimes called Dukes’ A Colon Cancer. 
  • Rectal: In stage I, cancer has spread beyond the innermost lining of the rectum to the second and third layers and involves the inside wall of the rectum, but it has not spread to the outer wall of the rectum or outside the rectum. Stage I rectal cancer is sometimes called Dukes’ A Rectal Cancer. 
Stage II Colon:
Stage II is divided into stage IIA and stage IIB.
  • Stage IIA: Cancer has spread beyond the middle tissue layers of the colon wall or has spread to nearby tissues around the colon or rectum. 
  • Stage IIB: Cancer has spread beyond the colon wall into adjacent organs and/or through the peritoneum. The peritoneum is a thin membrane that lines the inside of the abdomen. Stage II Colon Cancer is sometimes called Dukes’ B Colon Cancer. 
Stage II Rectal:
In Stage II, cancer has spread outside the rectum to nearby tissue, but it has not gone into the lymph nodes. Stage II rectal cancer is sometimes called Dukes’ B Rectal Cancer.

Stage III:
Colon Stage III colon cancer is divided into stage IIIA, stage IIIB and stage IIIC.
  • Stage IIIA - Cancer has spread from the innermost tissue layer of the colon wall to the middle layers and has spread to as many as 3 lymph nodes. 
  • Stage IIIB - Cancer has spread to as many as 3 nearby lymph nodes and has spread beyond the middle tissue layers of the colon wall or beyond the colon wall into adjacent fat or organs and/or through the peritoneum. 
  • Stage IIIC - Cancer has spread to 4 or more nearby lymph nodes and has spread to or beyond the middle tissue layers of the colon wall or to adjacent fat or organs and/or through the peritoneum. Stage III colon cancer is sometimes called Dukes’ C colon cancer. 
Rectal
In stage III, cancer has spread to nearby lymph nodes, but it has not spread to other parts of the body. Stage III rectal cancer is sometimes called Dukes’ C Rectal Cancer. S

Stage IV:
Colorectal
 In stage IV, cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Stage IV Colorectal Cancer is sometimes called Dukes’ D Colorectal Cancer. It is also called advanced, or metastatic, cancer. Deciding on the best treatment for colorectal cancer depends on knowing the stage of the cancer.

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