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Dukes' stages of bowel cancer

Men and women discussing bowel cancer

There are 2 staging systems for bowel cancer used in the UK. This page tells you about how bowel cancer is staged using the Dukes' staging system. The TNM and number staging system is described on the previous page in this section. On this page there is information about

 

A quick guide to what's on this page

Dukes' stages of bowel cancer

The stage of a cancer means how big the cancer is and whether it has spread. It is important because treatment is often based on the stage of a cancer.

Bowel (colorectal) cancer can be staged according to the Dukes' system. You may hear your specialist talking about your bowel cancer as a Dukes' A, B, C or D.

  • Dukes' A means the cancer is only in the innermost lining of the colon or rectum or slightly growing into the muscle layer
  • Dukes' B means the cancer has grown through the muscle layer of the colon or rectum
  • Dukes' C means the cancer has spread to at least one lymph node in the area
  • Dukes' D means the cancer has spread to somewhere else in the body, such as the liver or lung. Some doctors prefer to call this stage 4, or advanced bowel cancer

Other systems are also used to stage bowel cancer. Doctors in the UK now often use the TNM system.

 

CR PDF Icon You can view and print the quick guides for all the pages in the treating bowel cancer section.

 

 

What staging is

The stage of a cancer means how big it is and whether it has spread. The tests and scans you have when diagnosing your cancer give some information about the stage. It is important because treatment is often based on the stage of a cancer.

It may not be possible to stage the cancer properly until after your operation. But the scans and tests may give your doctor an idea of the stage, and sometimes a decision can be made about giving other treatment before surgery.

The TNM staging system is commonly used in the UK. The TNM system gives a detailed description of the size of your tumour and whether it has spread to nearby lymph nodes or to another part of your body. There is information in this section about TNM staging and number staging. The Dukes' system is described below.

 

The Dukes' system

You may hear your specialist talking about your bowel cancer as a Dukes' A, B, C or D. The different stages are explained below.

Dukes' A means the cancer is only in the innermost lining of the colon or rectum or slightly growing into the muscle layer.

Diagram showing Dukes' A bowel cancer

Dukes' B means the cancer has grown through the muscle layer of the colon or rectum.

Diagram showing Dukes' B bowel cancer

Dukes' C means the cancer has spread to at least one lymph node in the area close to the bowel.

Diagram showing Dukes' C bowel cancer

Dukes' D means the cancer has spread to somewhere else in the body such as the liver or lung.

Diagram showing Dukes' D bowel cancer

At first, the Dukes' staging system only included the first 3 stages (A, B, and C) but it was later changed to include Dukes' stage D. Some doctors prefer to call bowel cancer that has spread stage 4, or advanced bowel cancer, rather than Dukes' stage D.

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Updated: 13 August 2013