Colorectal cancer is the most common cancer of all genders, with more than 40,000 new cases appearing each year and nearly 18,000 deaths. The 5-year survival rate tends to increase because treatments are constantly progressing, thanks to improved surgery and chemotherapy.

The choice of treatment depends on the stage and location of cancer. It is never decided by a single professional but is the result of a multidisciplinary consultation meeting.

The different stages of colorectal cancer

Three criteria are used to determine the extent of colorectal cancer: the size and depth of the tumor, whether or not lymph nodes are involved and the number of lymph nodes affected, and whether or not there is metastasis.

It is on these 3 criteria that the TNM classification (Tumor, Nodes, Metastasis) is based, which determines colorectal cancers in 5 stages of increasing extension/gravity, ranging from 0 to IV :

Stage 0: The tumor is said to be in situ, i.e. it is very superficial and there is no deep or distant invasion.

Stage I: The tumor invades the submucosa, 2nd layer after the mucosa or muscle of the wall of the colon or rectum. The lymph nodes are unharmed and there is no metastasis.

Stage II: Malignant cells have passed through several layers but without lymphatic damage or metastasis.

Stage III: Malignant cells have invaded the lymph nodes near the tumor.

Stage IV: Cancer has spread beyond the colon or rectum, with distant metastases, usually to the liver or lungs.

Different treatments depending on the stage

The goal of the treatment is to cure cancer by eliminating all malignant cells, prevent the tumor from spreading, decrease recurrence, and improve the patient’s comfort and quality of life.

There are different types of treatments that will be used depending on the stage of cancer. First, surgery to remove the tumor, radiotherapy for rectal cancers, chemotherapy, and targeted therapies.

Depending on the case, one or more combined treatments will be required. When a complementary treatment is combined with surgery, for example, it is called adjuvant treatment, which is intended to enhance the effectiveness of the main treatment.

Colorectal cancer surgery

Surgery is the main treatment for colorectal cancer. The procedure consists of the removal of the affected segment of the colon. In the case of rectal cancer, the surgeon removes the rectum, preserving the sphincter if possible.

The removal of the mesorectum (the fatty area around the rectum that contains the blood and lymph vessels and nerves of the rectum) reduces the risk of recurrence.

In some cases, an ostomy may be necessary. This is an opening made by the surgeon in the abdomen to allow the evacuation of the stool to a special pouch located outside the body.

It may be temporary when it is made to protect the future. When cancer has been completely removed, the operation alone ensures healing.

Surgery combined with radiotherapy

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