Stages, types and grades
Stage 4 bowel (colon and rectal) cancer means the cancer has spread to other parts of the body, such as the liver or lungs. It's also called metastatic or advanced bowel cancer.
Stage 4 is divided into 3 stages - 4A, 4B and 4C.
Stage 4A means that the cancer has spread to 1 distant site or organ, for example the liver, but it hasn’t spread to the tissue lining your tummy (peritoneum).
The cancer spreads through the lymphatic system or the bloodstream.
Stage 4B means the cancer has spread to 2 or more distant organs, but it hasn’t spread to the tissue lining your tummy (peritoneum).
Stage 4C means the cancer may have spread to distant organs and it has spread to the lining of your tummy (peritoneum).
TNM stands for tumour, node and metastasis. In the TNM staging system, stage 4A is the same as:
any T, any N, M1a
Stage 4B is the same as:
any T, any N, M1b
Stage 4C is the same as:
any T, any N, M1c
Your doctor might recommend:
Get more information about these treatments
Your doctor might recommend:
surgery
chemotherapy
radiotherapy
chemotherapy combined with radiotherapy (chemoradiotherapy)
targeted cancer drugs
immunotherapy
Get more information about treatment for bowel cancer that has spread
Last reviewed: 11 Dec 2024
Next review due: 11 Dec 2027
The stage of a cancer tells you how far it has grown through the bowel wall and whether it has spread to nearby lymph nodes or other organs. It helps your doctor to know which treatment you need.
The aim of treatment for metastatic bowel cancer is usually to reduce symptoms, make you feel better and sometimes help you live longer.
If you have metastatic bowel cancer there is information and support available to you, your family and friends.
You usually start by seeing your GP and they might refer you to a specialist and organise tests. Get information on what happens, and read about screening for bowel cancer.
Bowel cancer means cancer that starts in the colon (large bowel) or back passage (rectum). It is also known as colorectal cancer.
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