Colorectal cancer stages

The article was written by Specialist Doctor I Nguyen Thi Minh Thuyen - Pathologist, Pathology Department - Vinmec Danang International General Hospital.

Cancer stage is classified to describe the extent of cancer in the body. It helps determine the severity of the disease and how best to treat it. Doctors also use cancer stages when talking about survival statistics.

The earliest stage colorectal cancer is called stage 0 (very early cancer), and then graded from stage I (1) to IV (4). As a rule, the higher the number, the more the cancer has spread.
The most commonly used staging system for colorectal cancer is the American Joint Committee on Cancer (AJCC) TNM system, which is based on 3 key pieces of information: size) of the tumor ( T - tumor ): Cancer has grown to any layer of the wall of the colon or rectum. Spread to nearby lymph nodes (N - lymph nodes): Has the cancer spread to nearby lymph nodes, and if so, how many? Spread (metastasis) to distant sites (M - metastasis): Has the cancer spread to prolapsed lymph nodes Or distant organs such as the liver or lungs?. The numbers Or letters after T, N, and M provide more details about each piece of information. A higher number means the cancer is more advanced.
Cancer staging can be complicated, so ask your doctor to explain it to you in a way you understand.

2.1 Stage 0 Tis N0 M0
Cancer in the earliest stage. This stage is also known as carcinoma in situ or intramucosal carcinoma (Tis). Cancer cells are confined to the innermost layer (mucosa) of the colon or rectum, and have not yet grown outside. 2.2 Stage I T1/T2 N0 M0
Cancer has grown through the muscularis mucosa into the submucosa (T1), and may have grown into the muscle layer (T2). Has not spread to nearby lymph nodes (N0) or to distant sites (M0). 2.3 Stage II IIA: T3 N0 M0
The cancer has grown to the outermost layers of the colon but has not made it past them (T3). Non-invasive to nearby organs. Has not spread to nearby lymph nodes (N0) or to distant sites (M0).

IIB: T4a N0 M0
Cancer has grown through the wall of the colon but has not invaded other nearby tissues or organs (T4a). Has not spread to nearby lymph nodes (N0) or to distant sites (M0). IIC: T4b N0 M0
Cancer has grown through the wall of the colon and has invaded other nearby tissues or organs (T4b). Has not spread to nearby lymph nodes (N0) or to distant sites (M0). 2.4 Stage III IIIA: T1/T2 N1/N1c M0
Cancer has grown through the mucosa into the submucosa (T1), and may have invaded the muscle layer (T2). Invasion of 1 to 3 nearby lymph nodes (N1) Or areas of fat near the lymph nodes but not the lymph nodes (N1c). Does not spread to distant locations (M0). Or T1 N2a M0
Cancer has grown through the mucosa into the submucosa (T1). Invasion of 4 to 6 nearby lymph nodes (N2a). Does not spread to distant locations (M0). IIIB: T3/T4a N1/N1c M0
Cancer has grown into the outermost layers of the colon (T3) or through the visceral peritoneum (T4a) but has not reached nearby organs. Invasion of 1 to 3 nearby lymph nodes (N1a or N1b) Or into areas of fat near the lymph nodes but not the lymph nodes (N1c). Does not spread to distant locations (M0).

Either T2/T3 N2a M0
Cancer has grown into the muscle layer (T2) Or to the outermost layers of the colon (T3). Invasion of 4 to 6 nearby lymph nodes (N2a). Does not spread to distant locations (M0). Or T1/T2 N2b M0
The cancer has grown through the mucosa into the submucosa (T1), and may also have grown into the muscle layer (T2). Invasion from 7 nearby lymph nodes (N2b). Does not spread to distant locations (M0). IIIC: T4a N2a M0
Cancer has grown through the wall of the colon (including the visceral peritoneum) but has not reached nearby organs (T4a). Invasion of 4 to 6 nearby lymph nodes (N2a). Does not spread to distant locations (M0). Or T3/T4a N2b M0
Cancer has grown into the outermost layers of the colon (T3). Or through the visceral peritoneum (T4a) but not reaching nearby organs. Invasion from 7 nearby lymph nodes (N2b). Does not spread to distant locations (M0). Or T4b N1/N2 M0
Cancer has grown through the wall of the colon and into other nearby tissues or organs (T4b). Invasion of at least one nearby lymph node Or into areas of fat near a lymph node (N1 Or N2). Does not spread to distant locations (M0).

IVA: any T any N M1a
Cancer may or may not have spread through the wall of the colon (any T). May or may not have spread to nearby lymph nodes (any N). Has spread to 1 distant organ (eg, liver, lung) to distant lymph nodes, but not to the distal parts of the peritoneum (the lining of the abdominal cavity) (M1a). IVB: Any T any N M1b
Cancer may Or may not have spread through the wall of the colon (any T). May or may not have spread to nearby lymph nodes (any N). Has spread to more than 1 distant organ (eg, liver, lung) or to distant lymph nodes, but not to distal parts of the peritoneum (the lining of the abdominal cavity) (M1b). IVC: T any N M1c
Cancer may or may not have spread through the wall of the rectum (any T). May or may not have spread to nearby lymph nodes (any N). Has spread to the distal parts of the peritoneum (the lining of the abdominal cavity), and may or may not have spread to distant organs or lymph nodes (M1c). There is no way to completely prevent cancer. But you can change your risk factors and take steps to help lower your risk of cancer. The best way to prevent and protect the health of you and your family is to get screened for cancer as soon as possible. It is recommended to repeat every 6 months, 1 year, 2 years... Periodic and correct cancer screening will help detect precancerous lesions early, thereby providing a chance to live and recover from the disease.
Vinmec International General Hospital is one of the most prestigious and modern hospitals in Vietnam. Here, rectal cancer screening packages are provided to help customers be proactive and prevent the disease.

Article referenced source: American Cancer Society