Dukes' staging system
Doctors use different systems for staging bowel cancer. The most common system for bowel cancer is TNM staging.
The Dukes' staging system is not really used anymore. But you might hear your doctor talking about your bowel cancer as Dukes’ A,B,C or D.
Dukes' A
The cancer is in the inner lining of the bowel. Or it is slightly growing into the muscle layer.
Dukes' B
The cancer has grown through the muscle layer of the bowel.
Dukes' C
The cancer has spread to at least 1 
close to the bowel.
Dukes' D
The cancer has spread to another part of the body, such as the liver, lungs or bones.
In the number staging system, this is the same as stage 4. It is also called metastatic or advanced bowel cancer.
Treatment
The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:
- your type of cancer (the type of cells the cancer started in)
- where the cancer is in your bowel (colon or rectum)
- other health conditions that you have
The stage of the cancer and these other factors can also give an idea of your outlook (prognosis).
The main treatments for cancer of the large bowel (colon cancer) are:
- surgery
chemotherapy
The main treatments for cancer of the back passage (rectal cancer) are:
- surgery
radiotherapy - chemotherapy
- chemotherapy and radiotherapy together (
chemoradiotherapy )
Metastatic cancer means your cancer has spread away from where it started. It is also called advanced cancer.
You might have chemotherapy or radiotherapy for bowel cancer that has spread. Sometimes you can also have surgery. This is to remove as much cancer as possible and help with your symptoms.
You might also have:
• a
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