If cancer has spread outside the rectum, it has invaded a lymph node, peritoneum, or distant organ. If cancer has spread to more than one organ, it is known as stage 4b. Surgical treatment may be needed to treat stage 4b cancer. But if the tumor has not spread to any other organ, it is considered stage 3.
When colon cancer is early staged, it can be removed without cutting the abdominal wall. Doctors can insert a thin tube containing a cutting tool and remove the cancer. These procedures are called polypectomy or local excision. In some cases, cancer cells may spread outside the rectum and are not detectable by surgery. While this treatment is not always possible, it can be a viable option for patients. If you have colon cancer that has spread to nearby organs, you may be eligible for this treatment.
Following treatment, your doctor will recommend follow-up visits based on your stage of colon cancer. A repeat colonoscopy will be recommended 1 year after treatment, then every three to five years. If the initial test shows an adenoma, you will need a repeat colonoscopy at one year after the surgery. Otherwise, you will need to undergo another procedure – endoscopic ultrasound-guided fine needle aspiration biopsy. A test known as a CEA assay measures the level of CEA in your blood, which may be indicative of colon cancer.
After determining the stage of your colon cancer, your doctor may recommend surgery or chemotherapy. If the cancer is advanced, you may undergo a partial colectomy, which removes the cancer and a small portion of healthy tissue surrounding it. After the surgery, your doctor may perform an anastomosis, which stitches the two ends of your colon together. Your doctor may also recommend a colostomy, a small opening in the abdomen wall that allows stool to pass. Depending on the stage of colon cancer, the surgery may require you to undergo chemotherapy or radiation therapy.
After surgery, you will have to undergo routine evaluations and blood tests. Chemotherapy can also reduce the likelihood of recurrence. The type of chemotherapy will depend on the stage of the disease, the location of the tumor, and your body’s tolerance for intensive chemotherapy. In addition, you may be tested for specific markers in the tumor that indicate whether it is resistant or sensitive to certain treatments. The doctor may use chemotherapy in combination with surgery if your cancer has spread to the liver.
Stage 4 of colon cancer is the most advanced stage. It has spread through the mucosa and submucosa of the colon wall. If it has spread to the lymph nodes, it can also invade nearby organs and tissues. The cancer can recur despite treatment, and it may even spread to other organs, such as the liver and lungs. And it is often fatal if untreated colon cancer spreads to other organs or lymph nodes.
