Colon Cancer Treatments Staging

Once a biopsy has confirmed the presence of a malignant tumor, several factors are considered when determining the most appropriate type of treatment for colorectal cancer (CRC).

Decisions about colon cancer treatment usually involve consultation with a team of experts consisting of a medical oncologist, radiation oncologist, cancer surgeon, and specialist nursing staff. Having a feel for all the treatment options available can help facilitate an easier discussion between you and your team. Use the Colon Cancer Treatment Options tool to learn more about treatments that may be appropriate for you.

Treatment choice depends largely on the size, location and stage of the tumor and whether the malignancy has spread to other parts of the body (metastasis). The patient’s state of health outside the cancer is also an important determinant.

Colorectal cancer is treatable. According to Bruce Orkin, MD, Director of Colon and Rectal Surgery, George Washington University, Washington, D.C., “Early detection is key . . . and we can provide many treatments for colorectal cancer that can remove cancerous tissue and preserve quality of life.”

Colon Cancer Stages

“Staging” refers to the procedure used by oncologists to establish the extent or stage of the disease and how far the cancer has spread. Accurate evaluation of cancer stage is crucial when planning the most appropriate form of colon cancer treatment. Staging is also an important tool for assessing prognosis.

The Duke’s system was the original system used for colorectal cancer and grouped patients into either Stage A, B, or C depending on the extent of the cancer- localized, spread through the intestinal wall, metastasis to lymph nodes. Stage D was later added to indicate evidence of metastases.

While the Duke’s system is still sometimes used, the most common system is the TNM (Tumor, Node, Metastasis) system:

  • T – Tumor: indicates the extent of the tumor (1-4).
  • N – Node: indicates the extent of lymph node involvement (0-2).
  • M – Metastasis: indicates the presence of metastases (0 = no, 1 = yes).

The cancer stages (I, II, III, IV) depend on the TNM evaluation:

  • Stage 0 – pre-cancerous or very early stage; confined to the most superficial layer of the colon and rectum.
  • Stage I – located within the two or three most superficial layers of the colon or rectum; no evidence of lymph node involvement.
  • Stage II – extended to the muscle wall of the colon; no evidence of lymph node involvement.
  • Stage III – evidence of lymph node involvement.
  • Stage IV – evidence of metastases frequently in the liver and/or the lungs.

Cancer Colon Treatment: An Overview

Once the stage of the cancer has been established by means of biopsy, the patient may be offered one or a combination of different types of treatment.


Surgical removal of the malignant tumor and affected lymph nodes is the most common type of treatment for colorectal cancer. The surgeon may also remove part of the healthy colon or rectum and surrounding lymph nodes.


Often used before or after surgery, chemotherapy uses anticancer drugs to kill cancer cells and to prevent and control metastasis. Chemotherapy is sometimes used to relieve symptoms.


Also called radiation therapy, radiotherapy uses localized high-energy x-rays to kill cancerous cells in the colon and more specifically in the rectum. It is often used prior to surgery to reduce the size of a tumor, after surgery to destroy any remaining cancer cells, and to relieve symptoms.

Experimental Immunotherapy (Biological Therapy)

Many clinical trials are currently underway to find more effective ways of treating CRC than present methods. Immunotherapy is one method under study and involves harnessing the body’s immune system to fight and destroy the cancer cells.

The Importance of Clinical Trials

Taking part in the latest research into colon cancer treatment can save lives. Clinical trials to test and evaluate new treatments for CRC play a vital role in improving a patient’s chance of survival.