Treating Stage 2 Colorectal Cancer

Following your colorectal cancer diagnosis, your team of doctors will begin to advise you on the treatment options that are available, and which are most suitable for your diagnosis. Depending on your stage, cancer/tumor type and genetics, some treatments may be more or less effective than others, and having a better understanding of what to expect can help you make more informed decisions.

In this series of articles, we cover the treatment that you may be recommended based on the cancer stage when you are diagnosed. We hope this helps you keep a positive mindset while preparing for the next phase of your journey with cancer.

This article will outline and explain the available and likely treatments for stage 2 colorectal cancer.

Stage 2 colorectal cancer is similar to stage 1 in that it remains fairly localized and has not spread far from its point of origin. However, based on the American Joint Committee on Cancer (AJCC) TNM system, the cancer is classified as stage 2 if it has grown into the serosa and fully penetrated the intestinal wall and reached the visceral peritoneum. It is also considered stage 2 if the cancer has spread to tissue and organs nearby.

Similar to earlier stages, surgery is one of the recommended ways to treat stage 2 colorectal cancer. More specifically, a partial colectomy may be required and a section of the colon is removed to prevent the cancer from spreading further.

Radiation and chemotherapy may also be used as neoadjuvant therapy and adjuvant therapy to shrink the tumor before surgery and remove any remaining cancer cells after surgery. This, however, depends on your biopsy results and if the cancer cells found are considered very abnormal.

If chemotherapy is required, the main options include 5-FU and leucovorin, oxaliplatin, or capecitabine, but other combinations may also be used. For the subgroup of colorectal cancer patients who have a deficiency in DNA mismatch repair (MMR) proteins, neoadjuvant or adjuvant immunotherapy is also recommended.

Stage 2 colorectal cancer is generally treated with a procedure referred to as a resection, where a section of the colon is removed, and the healthy ends are joined together. If the colon is obstructed, the surgeon is more likely to perform a colostomy or stoma. The healthy end of your small or large intestine is then pulled through an opening in the abdominal wall and stitched to the skin. A bag known as an ostomy bag is worn over the hole to collect stool and waste matter.

Sometimes, a colostomy may be done as a temporary measure to give your colon time to recover after the surgery. Whether temporary or permanent, a stoma will require changes to your diet and lifestyle, and should be discussed in detail with your medical team before proceeding.