Stage 2 Colon Cancer

What is stage 2 colon cancer?

Colorectal cancer is the world's third most common cancer, affecting both men and women [¹]. Stage 2 colon cancer is a type of colorectal cancer that affects the colon, which is the longest part of the large intestine. Stage 2 colon cancer is the second stage of colon cancer. In this stage, the cancer has grown beyond the innermost lining of the colon but has not yet spread to nearby lymph nodes or other organs. The tumor has grown into the muscular layer of the colon wall. The exact cause of colon cancer is unknown. Still, some factors can increase a person's risk of developing it, such as age (most people with colon cancer are over 50), family history, inflammatory bowel disease (Crohn's disease or ulcerative colitis), smoking, and more [²].

What are the substages of stage 2 colon cancer?

Grade 2 cancer is further divided into several subtypes, which are important to understand as they can impact treatment decisions and outcomes [³].

Stage 2A: This subtype describes a tumor that has grown through the innermost layer of the colon wall (the mucosa) and into the next layer (the submucosa). However, it has not spread to nearby lymph nodes or other organs.
Stage 2B: In this subtype, the tumor has grown through the muscle layer of the colon wall (the muscularis propria) and into the outermost layer (the serosa). Again, it has not spread to nearby lymph nodes or other organs.
Stage 2C: This subtype describes a tumor that has grown through the colon wall and has invaded nearby organs or tissues but has not spread to nearby lymph nodes.
Stage 2D: In this subtype, the tumor has invaded nearby organs or tissues and has spread to nearby lymph nodes.

The type of colon cancer is further classified based on the appearance of the cancer cells under a microscope. These classifications include:

Adenocarcinoma: the tumor develops from the cells lining the colon's inside.
Mucinous adenocarcinoma: This subtype of colon cancer produces mucus, making it more difficult to diagnose and treat.
Signet ring cell carcinoma: This subtype of colon cancer is characterized by cancer cells with a signet ring appearance under a microscope.
Undifferentiated carcinoma: This subtype of colon cancer is made up of cancer cells with no recognizable appearance.

Stage 2 colon cancer staging and diagnosis

Colon Cancer Staging

Colon cancer is divided into four main stages based on the progression level of the cancer. In general, the TNM system is used to describe and classify cancer based on tumor grade and is managed by The American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) [4].

T (tumor) describes the size and location of the tumor and can either be TX (no information), T0 (no evidence), Tis (the pre-cancer stage where cancer is growing in the tissue it was found), and any number between one to four after the T (The higher the number, the bigger the tumor or, the more it has spread).
N (nodes) indicates whether it has spread to nearby lymph nodes and can either be NX (no information about nearby lymph nodes), N0 (no cancer in nearby lymph nodes), or any number between one to four after N (the higher the number, the bigger the tumor or, the more it has spread to nearby lymph nodes).
M (metastasis) describes if and how far the cancer has spread from its origin and can either be M0 (the cancer did not spread) or M1 )the cancer has spread to distant organs.

How common is stage 2 colon cancer?

According to the National Cancer Institute, colon cancer is the fourth most common cancer, and prostate, lung, and colorectal cancers account for more than 43% of all cancers diagnosed in men and 50% of all cancers diagnosed in women [⁵]. According to the American Cancer Society, there have been more than 106, 970 new cases of colon cancer. Among these cases, more than a quarter were classified as stage II (also called Dukes’ B) colon cancer [⁶].

How is stage 2 colon cancer diagnosed?

On the first suspicion, a medical professional would recommend several tests to confirm the diagnosis of stage 2 colon cancer. Moreover, further testing would be required to confirm the progression of cancer. The medical professional will make a primary diagnosis based on the patient's signs and symptoms, medical history, and suspected cancer types. Then, the medical professional will recommend different medical tests, including:

Colonoscopy: A colonoscopy allows the doctor to see inside the rectum for signs of cancer. The procedure is performed by a colonoscopist that uses a colonoscope to look inside the rectum and colon and involves sedating the patient [⁷].
Biopsy: A biopsy is usually performed when signs of cancer are noticed and involve removing a small tissue sample for further examination in a microscope [⁸]. A biopsy helps provide a definite diagnosis of colon cancer and the stage of progression. The procedure typically involves a pathologist analyzing the sample in a laboratory.
Blood Tests: One of the most common blood tests for stage 2 colon cancer is a complete blood count (CBC) test, as colon cancer patients often bleed into the intestine or the rectum, causing them to become anemic [⁹]. The same principle is followed by fecal testing that involves checking for blood in the stool and involves either a guaiac-based fecal occult blood test (gFOBT) or the fecal immunochemical test (FIT). Another test is the carcinoembryonic antigen (CEA) test, which measures the amount of CEA in the blood, which is often high in colon cancer patients [¹⁰]. However, a CEA test may not be accurate as different factors contribute to the rise of CEA levels.
Imaging Tests: Imaging tests help locate and assess the extent of cancer and may involve a CT scan, an MRI, an x-ray, a positron emission tomography (PET) scan, and an ultrasound.

Stage 2 colon cancer symptoms

Some of the most common colon stage 2 cancer symptoms include:

Constipation
Diarrhea
Blood in stool
Rectal bleeding
Abdominal pain

However, symptoms of stage 2 cancer can way among patients, where some may experience milder symptoms. Thus, you must consult a doctor if you are experiencing any of these symptoms.

Stage 2 Colon Cancer Treatment

Stage 2 colon cancer primary/first-line treatment

The first-line treatment for stage 2 colon cancer is surgery. The American Society of Clinical Oncology recommends surgery as an effective treatment method for stage 2 colon cancer [¹¹]. The procedure involves removing or reducing the size of the tumor in a surgical resection, where part of the healthy colon is removed along with the cancer cells. Surgical options for stage 2 colon cancer treatment typically involve Laparoscopic surgery. The procedure involves using scopes passed into a patient's abdomen under anesthesia and making small incisions along the colon to remove the tumor [¹²].

Your doctor might also recommend radiation therapy after the surgery to kill any remaining cancer cells. The procedure involves using high-energy X-rays delivered to the cancer location five days a week for several weeks [¹³].

Other types of treatment for stage 2 colon cancer

The doctor might recommend other forms of treatment for patients who do not respond to or do not wish to have surgery. These treatment methods include:

Chemotherapy: Using drugs such as Capacetiabine, Fluorouracil, Oxaliplatin, etc. Over a set cancer treatment timeline and specific cycles to kill cancer cells or prevent them from growing [¹⁴]. Some medical professioanals might recommend chemo and radiation at the same time for improved efficacy.
Targeted Therapy: The use of medications that target cancer genes or proteins to inhibit the growth of cancer cells. These medications typically involve anti-angiogenesis drugs such as Bevacizumab or Regorafenib to prevent the growth of new blood vessels to the tumor [¹⁵].
Immunotherapy: The use of medication to improve or help the immune system in fighting against cancer [¹⁶]. The medication typically involves pembrolizumab, nivolumab, dostralimab, and ipilimumab.

Is colon stage 2 cancer curable?

While stage 2 colon cancer is an advanced form, it is considered one of the few curable cancers. There are several effective treatment methods available for stage 2 colon cancer. Although they may show different side effects, these methods are well-researched and accredited for curing stage two cancer. Research shows that stage 2 colon cancer surgery had an 85-88% survival rate without remission [¹⁷]. Moreover, certain supplements and lifestyle changes can help extend stage 2 cancer life expectancy.

Prognosis: Stage 2 colon cancer survival rate

Stage 2 cancer survival rate

According to the National Cancer Institute, There is a 65.1% five-year colon cancer stage 2 survival rate, which means that 65 out of a hundred patients will survive the first five years after diagnosis. Moreover, localized cancer has a 90.0% survival rate, while regional cancer has a 72.8% survival rate [¹⁸]. Moreover, the stage 2 colon cancer survival rate of ten years is around 55% [¹⁹].

Stage 2 colon cancer recurrence rate

Despite treatment for tumor, there is always a chance of the cancer coming back. Stage 2 colon cancer has a 10-12% recurrence risk following surgery, which can be lowered further with radiation therapy. Moreover, research showed that the recurrence rate for stage two cancer was higher in patients that did not receive chemotherapy than those that did [²⁰].

Stage 2 colon cancer growth rate

Colon cancer stage 2 is considered a relatively slow-growing cancer. However, there is little research on the tumor growth rate of colon cancer. One research study investigated the increase in the size of tumors following current management standards and found a median doubling time (the time it takes for the tumor to grow to double its original size) is around 211 days. Thus, colon cancer stage two is relatively slow growing but can grow fast without proper level of treatment or management.

Lifestyle changes for preventing and managing colon cancer

Colon cancer is often linked to lifestyle factors, including alcohol consumption, diet, and physical activity. You can adopt some lifestyle changes to help prevent the risk of colon cancer.

1. Diet

A healthy diet is essential for preventing colon cancer. Maintaining a high-fiber diet with fewer processed foods, red meat, and saturated fats can decrease the risk of colon cancer. Lean protein sources, such as poultry and fish, vegetables, whole grains, and fruits, can offer the crucial nutrients to maintain colon health [²¹].

2. Exercise

Exercising or any form of physical activity can also help prevent colon cancer and contribute to its management [²²]. Studies show that individuals who exercise regularly have a lower likelihood of developing colon cancer. Exercise can also help manage the symptoms of colon cancer, such as fatigue and nausea, and improve the overall quality of life.

3. Quit smoking

Smoking has been associated with many kinds of cancer, including colon cancer [²³]. Quitting can help decrease your risk of developing this cancer and also boost your overall wellbeing.

4. Limit alcohol consumption

Drinking alcohol in excess has been linked to an increased risk of colon cancer [²⁴]. If you choose to drink alcohol, limit your consumption to no more than one drink per day for women and two drinks per day for men.

5. Maintain a healthy weight.

Being overweight results in increased risk for developing colon cancer [²⁵]. Add a healthy diet and exercise to your routine to help reduce your risk of colon cancer and improve your overall health.

6. Regular screenings

Colon cancer screenings are crucial to prevent and manage this disease. Regular screenings can help detect colon cancer early, resulting in better treatment outcomes. Talk to your doctor about when you should start getting screened and how often you should be screened.

Conclusion

Takeaway

Stage 2 colon cancer is an advanced stage of colon cancer that demands swift and effective treatment. The earlier this cancer is detected and treated, the better your chances of a successful result. If you have a family history of colon cancer or are exhibiting its symptoms, consult with your doctor about preventative measures and screening to decrease your chances of developing this cancer. Prompt diagnosis and timely treatment help individuals with stage 2 colon cancer lead long, healthy lives.