Staging and prognosis for bowel cancer
These tests 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 team recommend the most appropriate treatment for you.
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In Australia, two main systems are used to stage bowel cancer:
- the Australian Clinico-Pathological Staging (ACPS) system
- the TNM (tumour–nodes–metastasis) staging system – in this system, each letter is assigned a number to show how advanced the cancer is.
Your doctor will combine the results of your early tests, as well as the tests on the cancer tissue and lymph nodes removed during surgery, to work out the overall stage of the cancer. The bowel cancer will be given a stage of 0–4 (often written in Roman numerals as 0, I, II, III or IV). In general, earlier stages have better outcomes. Almost 50% of bowel cancers in Australia are diagnosed at stage 1 or 2.
Stages of bowel cancer
|stage 1 (ACPS A)||tumour is found only in the lining of the bowel|
|stage 2 (ACPS B)||tumour has spread deeper into the layers of the bowel walls|
|stage 3 (ACPS C)||tumour has spread to nearby lymph nodes|
|stage 4 (ACPS D)||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 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. If cancer is found after it has spread beyond the bowel to other parts of the body, it may still respond well to treatment and can often be kept under control.
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. These details will also help your doctor advise you on the best treatment options.
A/Prof David A Clark, Colorectal Surgeon, Royal Brisbane and Women’s Hospital, and The University of Queensland, QLD, and The University of Sydney, NSW; A/Prof Siddhartha Baxi, Radiation Oncologist and Medical Director, GenesisCare Gold Coast, QLD; Dr Hooi Ee, Specialist Gastroenterologist and Head, Department of Gastroenterology, Sir Charles Gairdner Hospital, WA; Annie Harvey, Consumer; A/Prof Louise Nott, Medical Oncologist, Icon Cancer Centre, Hobart, TAS; Caley Schnaid, Accredited Practising Dietitian, GenesisCare, St Leonards and Frenchs Forest, NSW; Chris Sibthorpe, 13 11 20 Consultant, Cancer Council Queensland; Dr Alina Stoita, Gastroenterologist and Hepatologist, St Vincent’s Hospital Sydney, NSW; Catherine Trevaskis, Gastrointestinal Cancer Specialist Nurse, Canberra Hospital, ACT; Richard Vallance, Consumer.
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