Kathryn E. Vinson, MS, CCRC
In previous articles, we have discussed colon cancer and colorectal cancer in very specific terms, such as in “Colon Cancer Bacteria?” and “Can your toothbrush help you fight colon cancer?”. Today we are going to be specific as well, but focus on stage rather than bacterial causes, etc. About 39% of colorectal cancers are diagnosed at stage 2 or earlier and have a fairly good prognosis. Let’s take some time today to discuss stage 2 colon cancer, and what this diagnosis means for patients and families.
Colon cancer stages
As with other cancers, colon cancer diagnoses are divided by stage, but are also further classified by the T, N, M system and the G system. What does all this mean? T refers to the size and spread of the tumor, N refers to lymph node involvement, and M tells us the extent of metastases. The G grading system talks about how the cells look under a microscope, from being indistinguishable from healthy cells to no resemblance to a healthy cell.
Stage 2 colon cancer is divided into 3 sub-stages – 2A, 2B, and 2C – each with increasing levels of spread as follows:
Stage 2A: T3, N0, M0
Stage 2B: T4a, N0, M0
Stage 2C: T4b, N0, M0
It is important here to note that in all stage 2 levels, there is no spreading to the lymph nodes or metastases. The differentiation comes in how far the primary tumor has progressed through the wall of the colon, the abdominal muscles, and into other structures.
Risk factors and early detection
The good news about colon cancer is that it is being caught at much earlier stages than in the past, meaning that it is easier to treat. In line with that, the mortality rate dropped by 50% from 1975 to 2015 (28 per 100,000 to 14 per 100,000). If you are at a standard risk for developing colon cancer, the American Cancer Society recommends that you begin getting screening colonoscopies at the age of 50. I know, its not a procedure that the majority of us are excited about – but it can save your life! Doctors are able to see precancerous lesions in the wall of the colon and remove them before they develop into cancer. Medicare covers these tests, as well as the majority of major health plans, although co-pays may vary.
Risk factors for colon cancer include:
- Being inactive
- Eating lots of red or processed meats
- Not eating enough fruits, veggies, and whole grains
- Type 2 Diabetes
- Various genetic/hereditary factors
As with all cancers, colon cancer survival rates depend upon a host of factors, but most important among these is staging. Data from multiple sources, including the American Cancer Society, tells us that when colon cancer is diagnosed in early stages – and by this they mean that it hasn’t gone beyond localized disease, survival rates are as high as 90%! Once the cancer has spread to regional lymph nodes and other nearby structures, the rate drops to around 71%; if distant metastases are seen, the rate drops to only 14%. The average five-year survival rate across all stages for colon cancer is 64%.
Treatment for stage 2 colon cancer
In localized colon cancers, the most common treatment is surgery to remove the tumors. If the cancer has spread to nearby lymph nodes or other structures in the abdomen, chemotherapy or radiation may be used separately or in combination prior to surgery to shrink the tumors. Fortunately, permanent colostomies are not needed for the majority colon cancers, unless the rectum is also involved.
Targeted therapies (treatments that target certain genes or processes within the specific cancer cells) and immunotherapies (for more on immunotherapy, see “Immunotherapy and Cancer”) are being used now for more advanced stage colon cancers. Clinical trials are also an option for advanced cancers, so don’t be shy about discussing this option with your physicians.
As always, much love, abundant blessings, and many prayers to all of the cancer warriors and their families.