The cancer has grown through the first layer of the intestine into deeper layers (submucosa or muscularis) but has not spread outside the intestinal wall itself.
Primary surgery is usually either appropriate colorectal resection or abdominoperineal resection (if the cancer is found too low within the rectum).
Some small stage I rectal cancers may be treated by removing them through the anus without an abdominal incision, but many surgeons are now recommending radiation and chemotherapy for patients having such surgery.
The cancer has grown through the wall of the intestine (serosa) into nearby tissue. It has not yet spread to the lymph nodes.
Stage II rectal cancers are usually treated by appropriate colonic resection or abdominoperineal resection, along with both chemotherapy and radiation therapy. Radiation can be given either before or after the surgery.
In some cases of stage II rectal cancer, transanal full thickness rectal resection can be done after chemotherapy and radiation therapy. This approach can prevent the need for abdominoperineal resection and colostomy in some cases. A problem with this is there is no way of knowing whether the cancer has spread to the lymph nodes or further into the pelvis. For this reason, this procedure isn’t generally recommended.
Recurrent cancer means that the cancer has returned after treatment.
It may come back locally (near the area of the initial colorectal tumor) or in distant organs.
Surgery to remove local recurrences can extend survival.
If the recurrent tumor cannot be completely removed initially, combined chemotherapy and radiation therapy may be used, sometimes shrinking the cancer enough that complete surgical removal becomes possible.