Stages, types and grades
Stage 1 bowel cancer means that the cancer has grown through the inner lining of the bowel, or into the muscle wall, but no further.
There is no cancer in the lymph nodes.
TNM stands for tumour, node and metastasis. In the TNM staging system, stage 1 bowel cancer is the same as:
T1, N0, M0
T2, N0, M0
Surgery is the main treatment. People with very early colon cancer (stage 1) do not usually need chemotherapy.
But this might change after surgery. After your operation, a specialist doctor (pathologist) looks closely at your cancer. You might need further treatment if your cancer is more advanced than it looked from the investigations you had before surgery.
Read about surgery for colon cancer
The main treatment is surgery to remove the cancer. You might have a type of surgery called:
trans anal endoscopic microsurgery (TEM) – the surgeon removes the cancer along with a border (margin) of healthy tissue (you have this if you have a very early stage, low risk cancer)
total mesorectal excision (TME) - the surgeon removes the part of the rectum that contains cancer, as well as a border (margin) of healthy tissue around it, and the fatty tissue (mesorectum) around the rectum
If you can’t or don’t want to have surgery, your multidisciplinary team (MDT) will discuss your other treatment options. Your specialist will talk to you about these other treatments, as they might not work as well as surgery.
They might offer you:
internal radiotherapy (brachytherapy) instead of TEM
radiotherapy or chemoradiotherapy followed by TEM instead of TME
After your operation, a specialist doctor (pathologist) closely examines your cancer. You might need further treatment if this shows that your risk of the cancer coming back is higher than it looked from your investigations before surgery.
Further treatment after TEM might include:
more surgery – a total mesorectal excision (TME)
radiotherapy possibly with chemotherapy, if you can’t have surgery
Further treatment after TME might include:
chemotherapy and radiotherapy together (chemoradiotherapy)
Read about treatment for rectal cancer
Your doctor should let you know if there is a clinical trial that you might be able to take part in.
Find a clinical trial looking at bowel cancer
Last reviewed: 17 Dec 2024
Next review due: 17 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.
Treatment depends on whether you have colon or rectal cancer, as well as your cancer stage. You might have surgery, radiotherapy or chemotherapy or a combination of these.
Living with bowel (colorectal) cancer may mean you have changes to your diet, sex life or body image. There is support to help you cope.
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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