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Treatment of stage II colon cancer

The following are treatment options for stage II colon cancer. The types of treatments given are based on the unique needs of the person with cancer.

Surgery

Surgery is the primary treatment for stage II colon cancer. Surgery usually involves a bowel resection to remove the tumour and a margin of healthy tissue on each side of the tumour. The remaining 2 ends of the colon are joined together (anastomosis). The type of bowel resection depends on the location of the tumour and could include:

 

A temporary colostomy may be necessary if the colon cannot be reconnected because of stool contamination. It could also be used to let the lower colon rest and heal before being reconnected. A temporary colostomy is usually reversed within 3–6 months.

Chemotherapy

Most people with stage II colon cancer will not need chemotherapy. Adjuvant chemotherapy may be offered for stage II colon cancer when there is a high risk that the cancer will come back. High-risk colon cancer includes those that:

  • have a high grade
  • invade nearby organs (T4b tumours)
  • did not have adequate assessment of lymph nodes (less than 12 lymph nodes removed during surgery)
  • have cancer close to the margin of the tissue removed at surgery, indicating that there may still be cancer in the body
  • have spread to the blood vessels
  • block off the colon (bowel obstruction)
  • made a hole in the wall of the colon (bowel perforation)

 

People with high-risk stage II colon cancer have a greater chance that the cancer has spread microscopically (but has not yet developed into visible tumours elsewhere in the body). They may benefit from adjuvant chemotherapy.

 

The types of chemotherapy treatment that may be offered for stage II colon cancer are:

  • FOLFOX – oxaliplatin (Eloxatin) combined with 5-fluorouracil (Adrucil, 5-FU) and folinic acid (leucovorin)
  • 5-fluorouracil and folinic acid
  • capecitabine (Xeloda)

Radiation therapy

Most people with stage II colon cancer will not receive radiation therapy. Radiation therapy may be offered for stage II colon cancer to reduce the risk of the cancer recurring if the doctor thinks cancer cells may have been left behind after surgery. Radiation therapy may be given if:

  • there are areas of adhesions where cancer has spread into nearby tissues of the abdomen
    • After surgery, it may not be possible to tell if all of the cancer was removed because of the adhesions. Radiation therapy may be given to try to destroy any remaining cancer cells.
  • cancer is found very close to or invades the margin of tissue removed during surgery

Clinical trials

People with colon cancer may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.

References

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