Intestines inside a body

Colorectal Cancer Treatment by Stage


  • Doctors determine colorectal cancer treatment by stage.
  • Early-stage disease is easier to cure than late-stage colon cancer.
  • Stage 0 and stage I colon cancer treatments rely on surgery.
  • For stages II, III, and IV, doctors use chemotherapy, radiation treatment, and other methods.
  • Regular at-home screening can help you detect colon cancer early. 

Doctors choose options for colorectal cancer treatment by stage. The disease progresses through five stages, from 0 through IV. Treatment options become more complex as the disease progresses. At-home colorectal cancer screening can help you detect cancer in the early stages, when it’s easier to treat and survival rates are high. 

Colorectal Cancer Treatment by Stage

Treating colorectal cancer is a complex process involving several doctors. The team that sets your treatment consists of: 

  • A gastroenterologist. This doctor specializes in the functions of the digestive tract.
  • A medical oncologist. This specialist diagnoses and treats cancer through drugs, targeted therapy, hormone therapy, and biological therapy.
  • A radiation oncologist. This doctor treats cancer with radiation therapy.
  • A surgeon. Surgeons are experts in removing cancerous tissue, polyps, and organs. 

When agreeing upon the best treatment strategy, doctors consider the stage of the disease as well as the following factors: 

  • The potential side effects of the treatments
  • The overall health of the patient
  • The patient’s preferences
  •  Any other factors the doctors deem important 

Make sure you understand your treatment options and implications before beginning your treatment. Talk to your doctor about your preferences and treatment expectations. 

Colon cancer graphic
The stage of colon cancer is the top factor that determines treatment

Stages 0f Colorectal Cancer Treatment

Stage 0 represents a very early stage of the disease. During stage 0, the cancer cells have not spread beyond the lining of the colon. In some cases, your doctor may spot and remove a cancerous polyp during the colonoscopy, requiring no further treatment. 

If cancer has spread to the lining of your colon, the doctor may recommend the partial removal of the colon. 

Stage I Colorectal Cancer Treatment

Stage I colorectal cancers have spread into the colon wall but have not reached organs beyond the colon wall. The lymph nodes next to the outer colon wall are still healthy. 

Stage I colon cancers may be high grade or low grade. With low-grade cancers, doctors can tell apart cancer cells and healthy cells relatively easily. With high-grade cancers, it’s more difficult to distinguish healthy cells from cancerous ones. 

With stage I cancers, doctors usually turn to surgery. The standard approach is to remove the cancer-affected part of the colon along with the lymph nodes. Surgical resection is the first option. Doctors may also opt for laparoscopic surgery to remove the cancer. Laparoscopic surgery involves the insertion of scopes and other tools into the abdomen under anesthesia. 

Stage II Colorectal Cancer Treatment

Stage II colorectal cancers have grown into the tissue surrounding your colon wall but have not yet reached the lymph nodes. Surgical resection and laparoscopic surgery are standard treatment options for these cancers.

The removal of the affected colon section and nearby tissue and lymph nodes can resolve this problem. 

Depending on the gravity of the disease, your doctor may recommend adjuvant, or post-treatment, chemotherapy to enhance tumor suppression. Chemotherapy consists of a selection of drugs patients take to suppress cancer and stop it from returning. 

With stage II colon cancer, doctors may recommend the following drugs: 

  • Oxaliplatin
  • Capecitabine
  • Leucovorin
  • 5-FU
  • Other drugs and drug combinations 

When do you need adjuvant chemotherapy? In some cases, stage II colorectal cancer may become more serious and more likely to return following surgery. 

Your doctor might recommend adjuvant chemotherapy if:

  • Cancer perforates the colon wall or blocks the colon.
  • The cancer is high grade.
  • There are cancer cells on the edges, or margins, of the removed tissue.
  • Cancer affects blood vessels.
  • The surgeon has removed only a few lymph nodes. 

Doctors tend to disagree on when patients need adjuvant chemotherapy. Talk to your doctor to understand the risks and benefits of this approach. 

Bear in mind that stage II colon cancer can be high risk or low risk. Your risk profile determines the need for adjuvant chemotherapy. 

Stage III Colorectal Cancer Treatment

A stage III colon cancer has spread to the lymph nodes around the affected area but not to other organs. Surgery is the standard treatment option for stage III cancer. Doctors will use adjuvant chemotherapy to prevent the recurrence of cancer cells. 

For some stage III cancers, radiation therapy may also be an option. 

  • Doctors may use radiation treatment to shrink large cancers before surgery.
  • There may be remnants of cancerous cells left behind after surgery. Radiation can kill off those cells.
  • Doctors may resort to a combination of radiation therapy and chemotherapy to treat stage III colorectal cancer when surgery is not an option.
  • During surgery, radiation therapy can ensure that no cancer cells remain active.

Stage IV Colorectal Cancer Treatment

Late-stage cancer has spread to organs like the liver, brain, lungs, or distant lymph nodes. Surgery is no longer a viable treatment option for these cancers. 

In some cases, when the spread of the cancer is limited, doctors may try multiple surgeries to treat the disease.

Chemotherapy is usually the go-to option for stage IV colorectal cancer. A wide range of drug combinations can target cancer cells in many organs. Once the cancers shrink, doctors may attempt to remove them through surgery. 

If your doctor recommends surgery, make sure you understand its goal. Surgery may relieve symptoms, reduce cancer, or try to eliminate it. 

After the surgery, doctors may recommend an additional round of chemotherapy. 

Even though radiation alone is unlikely to kill off cancers, it can be used to reduce them enough for surgical removal.  

For some patients, immunotherapy may also be an option. Immunotherapy consists of drugs that might include nivolumab or pembrolizumab.

To treat cancer that has spread to other organs, oncologists may resort to embolization and ablation

Early Detection is the Key to Successful Treatment

The earlier you catch colon cancer, the easier it is for your doctors to cure you. When determining your treatment options, your doctors consider the stage of your colorectal cancer. 

Large intestine image in doctor's hands
Colon cancer screening saves lives

The key to early detection is regular screening. At-home FIT tests allow you to screen for colon cancer regularly without going to a hospital. At-home testing is cheaper and less invasive than colonoscopy. 

eDrugstore Can Help You Screen for Colon Cancer

With colorectal cancer, early discovery makes all the difference. Order your colorectal screening kit online from eDrugstore. We offer free shipping. All you have to do is collect your sample, return the kit, and get your results in two to five days. If your results are positive, we will also provide a free doctor consultation to discuss next steps. 

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