Colon and Rectal Cancers - Prevention

Treatment

A diagnosis of cancer will lead to staging and other tests to help determine the outlook and the appropriate treatments. Treatment for colorectal cancer includes surgery, chemotherapy, and radiation. These treatment methods may be combined.

• Surgery is used for early-stage colorectal cancer. Usually, the tumor is removed along with part of the colon and nearby lymph nodes.
• Chemotherapy may be given after surgery to kill any remaining cancer cells. It may also be given along with radiation before surgery to reduce tumor size.
• Radiation therapy is not usually used in early-stage colon cancer, but is commonly used to treat early-stage rectal cancer. It is often combined with chemotherapy.
• Clinical trials are available for individual stages of colorectal cancer.

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Colorectal Cancer Stages and Treatment Options

There are several methods for staging colorectal cancer. The older system, known as Dukes', categorizes four basic stages: A, B, C, and D. The newer TMN system evaluates the tumor (T), lymph node (N), and how far the cancer has spread or metastasized (M). The results of TMN are combined to determine the stage of the cancer.

Colorectal cancer stages and treatment options are: Stage 0 (Carcinoma in situ).

• In stage 0, cancer cells are fully contained in the innermost lining (mucosa) of the colon or rectum, and have not yet invaded the wall of the colon
• Treatment for stage 0 cancer usually involves surgical removal of the polyp (polypectomy) during colonoscopy.

Stage I.

• In stage I, the cancer has spread through the mucosa of the colon wall into middle layers of tissue.
• Treatment for stage I involves resection of the tumor. The tumor may be removed along with part of the colon (colectomy).

Stage II.

• In stage IIA, the cancer has spread beyond the middle layers to the outer tissues of the colon or rectum. In stage IIB, the cancer has penetrated through the colon or rectum wall into nearby tissue or organs.
• Treatment for stage II cancer involves surgical resection. Chemotherapy after surgery (adjuvant chemotherapy) plus radiation is considered standard treatment for stage II rectal cancer, but is under debate for stage II colon cancer.