Stages of Rectal Cancer
Key Points for This Section
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After rectal cancer has been diagnosed, tests are done
to find out if cancer cells have spread within the rectum or to other parts of
the body.
The process used to find out whether cancer has spread within the rectum or to other parts of the body
is called staging. The information gathered from the
staging process determines the stage of the disease. It is important
to know the stage in
order to plan treatment. The following tests and
procedures may be used in the staging process:
- Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan (CAT scan):
A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic
resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Endoscopic ultrasound (EUS):
A procedure in which an endoscope or rigid probe is inserted into the body through the rectum. The endoscope or probe has a light and a lens for viewing. A device at the end is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.
- PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
- Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of rectal cancer or other conditions.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for rectal cancer:
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As rectal cancer progresses from Stage 0 to Stage IV, the cancer cells grow through the layers of the rectum wall and spread to lymph nodes and other organs. |
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the innermost lining of the rectum. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in
situ.
Stage I
In stage I, cancer has
formed and spread beyond the innermost lining of the rectum to the second and third layers
and involves the inside wall of the rectum, but it has not spread to the outer
wall of the rectum or outside the rectum. Stage I rectal cancer is sometimes
called Dukes A rectal cancer.
Stage II
In stage II, cancer has spread outside the rectum to nearby tissue, but it has not gone into the lymph nodes (small, bean-shaped
structures found throughout the body that filter substances in a fluid called lymph and help fight infection and disease). Stage II rectal cancer is sometimes called Dukes B rectal
cancer.
Stage III
In stage III, cancer has spread to nearby lymph nodes, but it has not spread to other parts of the
body. Stage III rectal cancer is sometimes called Dukes C rectal cancer.
Stage IV
In stage IV, cancer has spread to other parts of the body, such as the liver, lungs, or ovaries. Stage IV rectal cancer is sometimes
called Dukes D rectal cancer.
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