Intestinal Cancer Staging

Staging Intestinal Cancer 

The small intestine is a long coiled tube in the gastrointestinal tract measuring three and half times the length of the body. There are five types of cancer that may affect the small intestine, but adenocarcinomas are the most common. The cancer may also be named for its location within the small bowel (the duodenum, jejunum or ileum).

Most adenocarcinomas of the small intestine develop in the duodenum, the first section that connects to the stomach. The location of the cancer is an important piece of information for diagnosing and staging the cancer. Once the cancer is identified and the diagnosis is confirmed, the size and spread of the cancer is evaluated in a standardized process called staging.

Intestinal cancer staging begins by evaluating three key components of the cancer: size, location and spread. In the earliest stages of intestinal adenocarcinomas (stage 0), the cancer has not spread and tumors are localized to the inner layer (mucosa) of the small intestine.

Later stages are characterized by the growth and spread of cancerous tissues into the layers of the intestinal wall. In the most advanced stage (stage IV), the cancer has typically grown through the intestinal wall and spread into nearby tissues.

Understanding the TNM System

Adenocarcinomas are typically staged using the American Joint Committee on Cancer's (AJCC) TNM system. Some types of cancers, like carcinoid tumors, do not have a standard staging system. In this case, the spread of the cancer is simply defined as localized, regional or distant. The stages described here are for the more common adenocarcinomas and are defined using the TNM system.

The combined categories, T, N and M, create the stages 0-IV:

• Tumor - The tumors are rated on a scale 0-4, where T0 indicates no evidence of the primary tumor expanding into local tissue, and the increasing numbers (T1-T4) describe the extent and spread of tumor into and through the intestinal wall. Carcinoma in situ, Tis, describes an early cancer that has not gone beyond to the inner muscle layer (the mucosa).
• Node - If cancer is found in the lymph nodes, the quantity of cancer cells found is rated using N1 or N2. Conditions where the cancer has not spread to the lymph nodes is indicated by N0.
• Metastasized - Cancer that has spread (metastasized) is indicated by M1. Otherwise, M0 is used if there are no signs of metastases.

Each category (T, N and M) is assessed and rated. An X is used to denote insufficient information (the condition of the particular factor cannot be adequately assessed).

Intestinal Cancer Stage Grouping

The combined categories, T, N and M, create the stages 0-IV:

• Stage 0 Intestinal Cancer:  The cancer has not grown beyond the mucosa (inner muscle). (Example: Tis, N0, M0)
• Stage I Intestinal Cancer:  The cancer has grown beyond the mucosa (inner muscle) but has not spread beyond the small intestines to other sites or lymph nodes. (Example: T1, N0, M0 or T2, N0, M0)
• Stage II Intestinal Cancer:  The cancer has grown into or through the intestinal wall. At this stage, it may or may not have reached nearby organs. There is no evidence of spread to lymph nodes or distant sites. (Example: T3, N0, M0)
• Stage III Intestinal Cancer:  The cancer has metastasized and spread to nearby lymph nodes. The tumor may be any size (T1-T4). The cancer may or may not have reached nearby organs. Distant sites, like the lung or liver, remain unaffected. (Example: T1, N1, M0)
• Stage IV Intestinal Cancer:  The cancer may be any size and has spread throughout the body to distant sites like the liver, lung, or lining of the abdominal cavity. (Example: Any T, Any N, M1)

Taking the Next Steps

The staging process provides a lot of valuable information for you and your doctors; and we are here every step of the way to answer your questions and support you through this process.

There may be a lot of new information to consider and the CTCA care team is dedicated to ensuring that you clearly understand the process and the variety of treatment options available to you. With knowledge, expertise and compassion, our cancer experts clearly communicate the information you need to know.

When you're ready to learn more, call 888-841-9129 or Chat Now to talk with one of our Oncology Information Specialists. Our representatives are available 24 hours a day, every day of the week. We're ready to help, at any stage.

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