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Colorectal Cancer Treatment by Stage

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Stage III Colorectal Cancer

Stage III colorectal cancers have spread outside the colon to one or more lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Tumors within the colon wall, which also involve the lymph nodes are classified as stage IIIA, while tumors that have grown through the colon wall and have spread to one to four lymph nodes are classified as stage IIIB cancers. Those tumors, which have spread to more than four lymph nodes are classified as stage IIIC colon cancers.

Treatment involves:

  • Surgery to remove the tumor and all involved lymph nodes if possible.
  • After surgery, the patient will receive chemotherapy with 5-FU, leucovorin and oxaliplatin, capecitabine with oxaliplatin or capecitabine alone.
  • Radiation may be needed if the tumor is large and invading the tissue surrounding the colon.

The five-year survival rate for stage III colon cancer is about 64%. Patients with one to four positive lymph nodes have a higher survival rate than people with more than five positive lymph nodes.

Stage IV Colorectal Cancer

Stage IV colorectal cancers have spread outside the colon to other parts of the body, such as the liver or the lungs. Cancer that has spread is also called "metastatic." The tumor can be any size and may or may not include affected lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).

Treatment may include:

  • Removal of the cancer surgically or another surgical procedure to bypass the colon cancer and hook up healthy colon (an anastomosis).
  • Surgery to remove parts of other organs such as the liver, lungs, and ovaries, where the cancer may have spread.
  • Chemotherapy to relieve symptoms and improve survival.
  • Erbitux, Avastin, or Vectibix in combination with standard chemotherapy, depending upon tumor characteristics.
  • Zaltrap is a drug also approved for use with chemotherapy in cases where the cancer has progressed or is resistant to treatment.
  • Stivarga is a targeted therapy approved in patients whose cancer has progressed after previous therapy.
  • Clinical trials of new chemotherapy regimens, or immunological therapy.
  • Radiation to relieve symptoms.

The five-year survival rate for stage IV colon cancer is nearly 8%.

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