Stage 0 (Carcinoma in Situ)
Stage I Colon Cancer
Stage II Colon Cancer
Stage III Colon Cancer
Stage IV and Recurrent Colon Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stage 0 (carcinoma in situ) may include the following types of surgery:

• Local excision or simple polypectomy.
• Resection /anastomosis. This is done when the tumor is too large to remove by local excision.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 colon cancer ¹.

Treatment of stage I colon cancer is usually resection /anastomosis.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I colon cancer ².

Treatment of stage II colon cancer may include the following:

• Resection /anastomosis.
• Clinical trials of chemotherapy, radiation therapy, or biologic therapy after surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II colon cancer ³.

Treatment of stage III colon cancer may include the following:

• Resection /anastomosis with chemotherapy.
• Clinical trials of chemotherapy, radiation therapy, and/or biologic therapy after surgery.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III colon cancer ⁴.

Treatment of stage IV and recurrent colon cancer may include the following:

• Resection /anastomosis (surgery to remove the cancer or bypass the tumor and join the cut ends of the colon).
• Surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread.
• Radiation therapy or chemotherapy may be offered to some patients as palliative therapy to relieve symptoms and improve quality of life.
• Clinical trials of chemotherapy and/or biologic therapy.

Treatment of locally recurrent colon cancer may be local excision.

Special treatments of cancer that has spread to or recurred in the liver may include the following:

• Chemotherapy followed by resection.
• Radiofrequency ablation or cryosurgery.
• Clinical trials of hepatic chemoembolization with radiation therapy.

Patients whose colon cancer spreads or recurs after initial treatment with chemotherapy may be offered further chemotherapy with a different drug or combination of drugs.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV colon cancer ⁵ and recurrent colon cancer ⁶.

Glossary Terms

A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed.

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called immunotherapy, biotherapy, biological response modifier therapy, and BRM therapy.

A surgical procedure in which the doctor creates a new pathway for the flow of body fluids.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A group of abnormal cells that remain in the tissue in which they first formed. These abnormal cells may become cancer and spread into nearby normal tissue.

A procedure in which the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.

Cancer that forms in the tissues of the colon (the longest part of the large intestine). Most colon cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).

A procedure in which tissue is frozen to destroy abnormal cells. This is usually done with a special instrument that contains liquid nitrogen or liquid carbon dioxide. Also called cryoablation.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

Removal by surgery.

Refers to the liver.

A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

An invasive malignant cancer confined entirely to the organ where the cancer began.

Treatment that affects cells in the tumor and the area close to it.

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

A part of the body that performs a specific function. For example, the heart is an organ.

One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

Surgery to remove a polyp.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

The use of electrodes to heat and destroy abnormal tissue.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

A procedure that uses surgery to remove tissue or part or all of an organ.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Abnormal cells are found in the innermost lining of the colon and/or rectum. These abnormal cells may become cancer and spread into nearby normal tissue.

Cancer has spread beyond the innermost lining of the colon and/or rectum to the second and third layers and involves the inside wall of the colon and/or rectum, but it has not spread to the outer wall or outside the colon and/or rectum. Also called Dukes A colorectal cancer.

Cancer has spread outside the colon and/or rectum to nearby tissue, but it has not gone into the lymph nodes. Also called Dukes B colorectal cancer.

Tumor cells have spread to organs and lymph nodes near the colon/rectum. Also called Dukes C colorectal cancer.

Cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Also called Dukes D colorectal cancer.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.