Colon cancer that has been diagnosed as Stage 2, is typically categorized into one of three subcategories referred to as Stage 2A (T3, N0, M0), Stage 2B (T4a, N0, M0), or Stage 2C (T4b, N0, M0).
For colon cancer to be classified as Stage 2A, the cancer has grown through the outermost layers of the colon, but has not yet grown through these layers. For Stage 2B, the tumor has grown through the wall of the colon. For Stage 2C, the cancer has grown through the wall of the colon and has spread into other nearby organs. In all of these stages, the colon cancer is not yet found in the lymph nodes, or has spread to distant organs.
Treatment for Stage 2 colon cancer typically consists of the surgical removal of the tumor, which may be the only treatment recommended. However, depending on how the cancer looks under a microscope and other factors that designate it as likely having a higher risk of recurrence, chemotherapy given after surgery may be recommended. Since there is no standard chemotherapy regimen for Stage 2 colon cancer, it is important to discuss whether or not chemotherapy is necessary with an oncologist.
If chemotherapy is given, it may include a regimen called FOLFOX (a triple combination of three agents including 5-FU, leucovorin and oxaliplatin), 5-FU and leucovorin combination treatment (without oxaliplatin), or another drug called capecitabine, which is usually given alone. Radiation therapy also may be recommended in order to kill any remaining cancer cells after surgery.
About Staging
The stage of colon cancer at diagnosis, or the extent to which it is present in the body, is typically determined by a staging system developed by the American Joint Committee on Cancer (AJCC) called the TNM System. Determining the stage of the colon cancer is one of the most vital factors in determining the most appropriate treatment options.
The AJCC TNM system evaluates the tumor based on the following criteria:
- T Category
- Describes the size of the primary tumor, which is measured in centimeters. The colon consists of several layers that form the wall of the colon, so it is important to know the extent of the growth into the wall of the intestine.
- N Category
- Whether or not the colon cancer has spread to nearby lymph nodes.
- M Category
- Describes the absence or presence of distant metastasis, or spread of the cancer, to other organs.
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