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Treatment depends partly on the stage of the cancer. This means how far the tumor has spread through the layers of the intestine, from the innermost lining to outside the intestinal wall and beyond:
- Stage 0: Very early cancer on the innermost layer (more accurately considered a precursor to cancer)
- Stage I: Tumor in the inner layers of the colon
- Stage II: Tumor has spread through the muscle wall of the colon
- Stage III: Tumor that has spread to the lymph nodes
- Stage IV: Tumor that has spread to distant organs
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Stage 0 colon cancer may be treated by cutting out the lesion, often via a colonoscopy. For stages I, II, and III cancer, more extensive surgery to remove a segment of colon containing the tumor and reattachment of the colon is necessary. (See colon resection.) This procedure only rarely requires a colostomy.
Almost all patients with stage III colon cancer, after surgery, should receive chemotherapy (adjuvant chemotherapy) with a drug known as 5-fluorouracil given for approximately 6 - 8 months. This drug has been shown to increase the chance of a cure. There is some debate as to whether patients with stage II colon cancer should receive chemotherapy after surgery, and patients should discuss this with their oncologist.
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