A range of tests can help show whether you have bowel cancer and whether it has spread from the original site to other parts of the body. This is known as staging and it helps your health care team advise you on the best treatment options.
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Staging bowel cancer
The most common staging system for bowel cancer is the TNM system, which stands for tumour–node–metastasis. The Australian Clinico-Pathological Staging (ACPS) system may also be used in some hospitals.
The TNM system gives numbers to:
- how deep the tumour has gone into the bowel (T1–4)
- whether or not lymph nodes are affected (N1–2)
- whether the cancer has spread or metastasised outside the bowel (M0–M1).
Based on the TNM numbers, the doctor then works out the cancer’s overall stage (see below for more detail). Around half of all bowel cancers in Australia are diagnosed at stage 1 or 2.
The stage can be predicted before surgery based on the results of your early tests, but may be revised after surgery, following tests on the cancer tissue and lymph nodes removed during surgery.
Stages of bowel cancer
| stage 1 | tumour is found only in the inner layers of the bowel wall |
| stage 2 | tumour has spread deeper into the layers of the bowel wall |
| stage 3 | tumour is in any layer of the bowel wall and has spread into nearby lymph nodes |
| stage 4 | tumour has spread beyond the bowel to other parts of the body, such as the liver or lungs, or to distant lymph nodes |
If you are finding it hard to understand staging, ask someone in your health care team to explain it in a way that makes sense to you.
Prognosis
Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease.
Your doctor can give you an idea about the common issues that affect people with bowel cancer. Generally, the earlier that bowel cancer is diagnosed, the better the chances of successful treatment, but people with more advanced bowel cancer may still respond well to treatment.
Test results, the type of cancer, the rate and depth of tumour growth, the likelihood of response to treatment, and factors such as your age, level of fitness and medical history are important in assessing your prognosis.
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Prof Alexander Heriot, Colorectal Surgeon and Director Cancer Surgery, Peter MacCallum Cancer Centre, Director, Lower GI Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; Dr Cameron Bell, Gastroenterologist, Royal North Shore Hospital, NSW; Graham Borgas, Consumer; Prof Michael Bourke, Director of Gastrointestinal Endoscopy, Westmead Hospital, The University of Sydney, NSW; Laura Carman, 13 11 20 Consultant, Cancer Council Victoria, VIC; Amanda Connolly, Specialist Bowel Care Nurse, Icon Cancer Centre Windsor Gardens, SA; A/Prof Melissa Eastgate, Operations Director, Cancer Care Services, Royal Brisbane and Women’s Hospital, QLD; Anne Marie Lyons, Stomal Therapy Nurse, Concord Repatriation General Hospital and NSW Stoma Ltd, NSW; Lisa Nicholson, Manager Bowel Care Services, Bowel Cancer Australia, NSW; Stefanie Simnadis, Clinical Dietitian, St John of God Subiaco Hospital, WA; Rafi Sharif, Consumer; Dr Kirsten van Gysen, Radiation Oncologist, The Nepean Cancer and Wellness Centre, NSW; Sarah Williams, Clinical Nurse Consultant, Lower GI, Peter MacCallum Cancer Centre, VIC.
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