Colorectal Cancer Treatment Depends on the Stage of the Disease: Let's Learn About This

It's normal to feel scared and shocked when you find out you have colorectal cancer. But it's important to be informed at times like these. Understanding what treatments you're going to receive and what to expect can be a huge help. Treatment for colorectal cancer depends largely on its "stage." Simply put, the treatment plan is determined by how far the cancer has spread.

Stage 0: The very beginning of cancer

This means the cancer is in its very early stages. This means the cancer cells are only in the thin lining of your colon or rectum. So this stage can often be completely cured with surgery.

The type of surgery you undergo will depend on the size of the tumor.

• For small tumors: The doctor may remove only the cancerous tumor and a very small piece of tissue around it. This is also called a ``Polypectomy.'' This can usually be done during a colonoscopy, a procedure that uses a camera to look into the colon.
• For large tumors: If the tumor is quite large, the doctor may have to cut out the cancerous part of the colon and reconnect the two healthy parts. This is called an anastomosis. After this, your intestines will function normally again.

Sometimes the doctor may also consider radiation therapy.

Stage I: Still manageable level

At this point, the cancer has spread beyond the lining of the colon, into the second and third layers. But most importantly, the cancer has not yet spread beyond the muscular wall of the colon, nor outside the colon.

At this point, the main treatment is still surgery to remove the cancer and a small amount of surrounding tissue. In most cases, additional treatments (such as chemotherapy) are not needed.

Stage II: Spread through the intestinal wall

In the second stage, the cancer cells are larger and have grown through the muscular wall of the colon. They may have spread to nearby organs such as the bladder, uterus (in women), or prostate gland (in men).

But the good news here too is that the cancer has not yet spread to the lymph nodes or to distant organs in the body.

At this time, the treatment is:

• The cancer and the surrounding tissue to which it has spread are surgically removed.
• Radiation therapy and chemotherapy may be given before or after surgery. These treatments are given before surgery to make the tumor smaller and easier to remove. They are given after surgery to destroy any remaining cancer cells and prevent the disease from coming back.

Stage III: Spread to the sebaceous glands

Stage 3 is when the cancer has spread to one or more lymph nodes. Lymph nodes are small structures that make cells that fight infection in our body and act like filters.

This stage is further divided into three parts: A, B, and C. Simply put:

• Stage IIIA: The cancer is within the colon wall and has spread to the lymph nodes.
• Stage IIIB: The cancer has grown through the wall of the colon and has spread to 1-4 lymph nodes.
• Stage IIIC: The cancer has spread to more than 4 lymph nodes and may have spread to nearby organs.

The treatment plan at this point usually looks like this:

• Surgery: If possible, the cancerous tumor and all associated lymph nodes are removed.
• Chemotherapy: Chemotherapy is usually given after surgery.
• Radiation therapy: If the cancer is large and has spread to surrounding tissues, radiation therapy may also be given.

Stage IV: Metastatic Cancer

Stage 4 is when the cancer has spread to distant organs in the body, especially the liver or lungs . Doctors also call this stage "metastatic" cancer. At this point, the main goal of treatment is to control the disease, reduce symptoms, prolong the patient's life as much as possible, and maintain a high quality of life.

Let's look at the main treatment methods used at this time in the table below.

What if the cancer comes back? (Recurrent Cancer)

Sometimes, cancer can come back after treatment. Doctors call this "recurrent cancer." This can be in the same place where the cancer was before or in another part of the body. This risk is slightly higher in people who had cancer at an advanced stage (e.g., Stage III).

Treatment if cancer recurs:

• Surgery: Studies have shown that if a relapsed cancer can be completely removed with surgery, it can help the patient live longer.
• Chemotherapy and radiation therapy: These treatments are used if surgery cannot completely remove the cancer. Sometimes these treatments can shrink the tumor so that it can be removed surgically later.
• Clinical Trials: These are studies of new drugs or treatments. Sometimes, this may give you the opportunity to try a new treatment that is not currently in common use. Talk to your doctor about this.