Rectal Cancer

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Colorectal Cancer Stages

The treatment that your doctor will recommend for colorectal cancer will be based, in part, on the stage of your cancer. The stage depends on:

  • How far the cancer has spread through the wall of your colon or rectum
  • Whether the cancer has spread to lymph nodes around your colon or rectum
  • Whether the cancer has spread to other parts of your body, such as your liver or lungs

There are four stages of colorectal cancer.

Stage I

Cancer has formed in the innermost layer of the colon/rectum wall. It has spread to the next layer (submucosa) and may have spread to the muscle layer.

Stage II

Cancer has spread through the muscle layer but not to the lymph nodes.

  • Stage IIA: Cancer has spread through the muscle layer to the outermost layer (serosa) of the colon/rectum wall.
  • Stage IIB: Cancer has spread through the outermost layer of the colon/rectum wall but not to any nearby organs. 
  • Stage IIC: Cancer has spread through the outermost layer of the colon/rectum wall to nearby organs.

Stage III

Cancer that started in the colon/rectum has spread to the lymph nodes.

  • Stage IIIA: Cancer may have spread through the innermost layer of the colon/rectum wall to the next layer (submucosa) and possibly the muscle layer, and it has spread to one to three nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; OR cancer has spread through the innermost layer of the colon/rectum wall to the next layer, and it has spread to four to six nearby lymph nodes.
  • Stage IIIB: Cancer has spread through the muscle layer of the colon/rectum wall to the outermost layer or through the outermost layer but not to nearby organs, and it has spread to one to three nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; OR cancer has spread to the muscle layer of the colon/rectum wall or to the outermost layer, and cancer has spread to four to six nearby lymph nodes; OR cancer has spread through the innermost layer of the colon/rectum wall to the next layer (submucosa) and may have spread to the muscle layer, and it has spread to seven or more nearby lymph nodes.
  • Stage IIIC: Cancer has spread through the outermost layer of the colon/rectum wall but not to nearby organs, and it has spread to four to six nearby lymph nodes; OR cancer has spread through the muscle layer of the colon/rectum wall to the outermost layer or through the outermost layer but not to nearby organs, and it has spread to seven or more nearby lymph nodes; OR cancer has spread through the outermost layer of the colon/rectum wall and to nearby organs, and it has spread to one or more nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes.

Stage IV

Cancer that started in the colon or rectum has spread to another organ (such as the liver) or a distant lymph node.

  • Stage IVA: Cancer may have spread through the colon/rectum wall and may have spread to nearby organs or lymph nodes, and it has spread to one other organ.
  • Stage IVB: Cancer may have spread through the colon/rectum wall and may have spread to nearby organs or lymph nodes, and it has spread to more than one other organ.