Stage 2

Stage 2 bowel (colon and rectal) cancer has spread into the outer wall of the bowel or into tissue or organs next to the bowel. It has not spread to the lymph nodes or distant parts of the body.

Stage 2 is divided into 3 stages -  2A, 2B and 2C.

Stage 2A

Stage 2A means that the cancer has grown into the outer lining of the bowel. 

Diagram showing Stage 2A bowel cancer

Stage 2B

Stage 2B means that the cancer has grown through the outer lining of the bowel into the tissue layer (peritoneum) covering the organs in the tummy (abdomen).

Diagram showing Stage 2B bowel cancer

Stage 2C

Stage 2C means that the cancer has grown through the wall of the colon or rectum, into organs and tissues next to it.

Diagram showing Stage 2C bowel cancer

TNM stages

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

In the TNM staging system, stage 2A bowel cancer is the same as:

  • T3, N0, M0.

Stage 2B is the same as:

  • T4a, N0, M0. 

Stage 2C bowel cancer is the same as:

  • T4b, N0, M0.

Treatment for stage 2 large bowel (colon) cancer

You have surgery to remove your cancer.

Your surgeon might suggest chemotherapy after surgery if you are at higher risk of cancer coming back. This depends on the results of your surgery. Chemotherapy can lower the chance of your cancer coming back after surgery.

Treatment for stage 2 rectal cancer of the back passage (rectal cancer)

The main treatments are:

  • surgery
  • radiotherapy
  • chemotherapy
  • chemotherapy combined with radiotherapy (chemoradiotherapy)

You might have:

  • surgery as your only treatment, or followed by chemoradiotherapy if the risk of your cancer coming back is higher than the surgeon previously thought
  • a short course of radiotherapy, followed by surgery
  • a course of chemoradiotherapy, followed by surgery

Further treatment

Your doctor might offer you chemotherapy after surgery if you have a high risk of your cancer coming back.

Other stages

Last reviewed: 
14 Jan 2022
Next review due: 
14 Jan 2025
  • Localised colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
    G Argilés and others
    Annals of Oncology, 2020. Volume 31, Issue 10 Pages 1291-1305

  • Colorectal cancer
    The National Institute for Health and Care Excellence (NICE), 2020. Updated December 2021

  • Rectal cancer: ESMO clinical practical guidelines for diagnosis, treatment and follow up
    R Glynne-Jones and others
    Annals of Oncology, 2017. Volume 28, Pages 422-440

  • AJCC Cancer Staging Manual (8th Edition)
    American Joint Committee on Cancer, 2017

  • Association of Coloproctology of Great Britain & Ireland (ACPGBI): Guidelines for the Management of Cancer of the Colon, Rectum and Anus (2017). 
    Colorectal disease Volume 19, issue S1,  Pages 1-97

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