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  • Staging and prognosis of bowel cancer



    Tests help show whether you have bowel cancer and whether it has spread. Working out how far the cancer has spread is called staging and it helps the doctor decide on the best treatment for you.

    There are different systems for staging bowel cancer. The Australian Clinico-Pathological Staging (ACPS) and Dukes staging system have been widely used in Australia, but TNM staging is becoming more common.

    When staging is done before surgery, it is known as the clinical stage—it represents your doctor’s estimate of the extent of the disease and is based on the tests used to diagnose the cancer. Staging done after treatment, such as surgery, is called the pathologic stage. This uses the findings of the early tests, as well as the tests on the cancer tissue and lymph nodes removed during surgery. These results are usually available about a week after the surgery. The pathologic stage is more precise in determining the extent of the cancer.


    Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis with your doctor, but it is not possible for any doctor to predict the exact course of the disease. In most cases, the earlier bowel cancer is diagnosed and treated, the better the outcome.

    To come up with a prognosis, your doctor will consider:

    • test results
    • the type of cancer you have
    • the rate and depth of tumour growth
    • other factors such as age, fitness and medical history

    If bowel cancer is diagnosed and treated when it is still confined to the colon and/or local lymph nodes, it is known as early bowel cancer and has a good prognosis. If the bowel cancer has spread beyond the colon and local lymph nodes, it is known as advanced bowel cancer. The cancer may respond well to treatment, but a cure is less likely.

    Which health professionals will I see?

    Your general practitioner (GP) will arrange the first tests to assess your symptoms, or further tests if you have had a positive screening test. You will usually be referred to a specialist, such as a colorectal surgeon or a gastroenterologist. The specialist will arrange further tests.

    Once your treatment for bowel cancer begins, you will be cared for by a range of health professionals who specialise in different areas of your treatment. This is called a multidisciplinary team (MDT) and it may include some or all of the health professionals listed in the table below.

    This website page was last reviewed and updated November 2018

    Information reviewed by: A/Prof Craig Lynch, Colorectal Surgeon and Chair, Lower Gastrointestinal Cancer Service, Peter MacCallum Cancer Centre, VIC; Merran Findlay, Executive Research Lead–Cancer Nutrition, and Oncology Specialist Dietitian, Royal Prince Alfred Hospital, NSW; Jackie Johnston, Palliative Care and Stomal Therapy Clinical Nurse Consultant, St Vincent’s Private Hospital, NSW; A/Prof Susan Pendlebury, Radiation Oncologist, St Vincent’s Clinic, NSW; Jan Priaulx, 13 11 20 Consultant, Cancer Council NSW; A/Prof Eva Segelov, Professor of Oncology, Monash Health and Monash University, VIC; Heather Turner, Consumer; Lynne Wolowiec, Consumer.

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