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Rectal Cancer (cont.)

How Do Doctors Determine Rectal Cancer Staging?

The treatment and prognosis of rectal cancer depend on the stage of the cancer, which is determined by the following three considerations:

  • How deeply the tumor has invaded the wall of the rectum
  • Whether the lymph nodes appear to have cancer in them
  • Whether the cancer has spread to any other locations in the body (Organs that rectal cancer commonly spreads to include the liver and the lungs.)

There are several ways to stage rectal cancer; Duke's classification (the first system to stage rectal cancers), Stage system I-IV, and the TNM classification (TNM represents T, the location of the tumor; N, the nodes [lymph nodes] invaded by tumor cells, and M, metastasis of tumor cells to other organs). The TNM classification is very detailed; many doctors choose to use the more simplified I-IV stages. This article will present this system. In general, all the classifications or stage systems describe the same process of cancer development.

The stages of rectal cancer are as follows:

  • Stage I: The tumor involves only the first or second layer of the rectal wall, and no lymph nodes are involved.
  • Stage II: The tumor penetrates into the mesorectum, but no lymph nodes are involved.
  • Stage III: Regardless of how deeply the tumor penetrates, the lymph nodes are involved with the cancer (this stage can be divided into IIIa, IIIb, and IIIc, depending how far the cancer has grown through rectal tissue or through its wall).
  • Stage IV: Convincing evidence of the cancer exists in other parts of the body, outside of the rectal area.

Localized rectal cancer includes stages I-III. Metastatic rectal cancer is stage IV. The goals of treating localized rectal cancer are to ensure the removal of all the cancer and to prevent a recurrence of the cancer, either near the rectum or elsewhere in the body.

Last Reviewed 9/11/2017

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