NCCN Guidelines for Patients
Colon Cancer, Version 1.2017
Stages II and III
Limited lymphadenectomy means fewer than
12 lymph nodes were examined.
Bowel obstruction means the tumor has grown
large enough to block the gut.
Localized perforation is the presence of holes in
the colon caused by the tumor.
If stage II, talk to your doctor about the pros and
cons of treatment. It is important to know that
chemotherapy may have little, if any, benefit.
Treatment decisions should be based on science,
side effects, cancer features, and your wishes.
If a stage II tumor is MSI-H or dMMR, no further
treatment is advised. The outlook (prognosis) of the
cancer is good. Also, 5-FU chemotherapy will not
help. You can start follow-up testing.
There are three options for stage IIA cancer that isn’t
MSI-H or dMMR and without high-risk features. First,
you can enroll in a clinical trial. Second, you can
start follow-up testing. Third, you can talk with your
doctors about starting chemotherapy. Capecitabine
alone or 5-FU/LV is advised.
High-risk stage IIA without MSI-H or dMMR, stage
IIB, and stage IIC cancers have four options.
Capecitabine or 5-FU/LV is one option. FOLFOX
or CAPEOX is another option. A T4 tumor that has
grown to a nearby structure may be treated with both
radiation and chemotherapy. The third option is to
join a clinical trial. A fourth option is to start follow-up
For stage III, chemotherapy is advised. The risk for
cancer returning after treatment is high. FOLFOX or
CAPEOX is often given for stage III. If oxaliplatin is
not right for you, other options are capecitabine alone
I always tell people going through
treatment two things: to get
themselves a "chemo buddy" like
a stuffed animal. It's not only
therapeutic for them, but other
patients and even the staff! And I
also tell people to let others help
you with things so you can focus on
getting through the treatment!
Survivor, Stage III