Colorectal Cancer Diagnosis: What is Your Prognosis?

5 min read


Colorectal Cancer Diagnosis: What is Your Prognosis?

After receiving a colorectal cancer diagnosis you may have searched online to understand the survival rate of colon or rectal cancer patients. The good news is that survival rates are improving for colorectal cancer patients due to many new and more targeted treatments that are now available.

It’s important to note however, that survival rates give you a sense of how many patients are still alive at least five years after they were diagnosed. It doesn’t mean that’s necessarily your personal prognosis or expected outcome.

Let’s take a look at survival rates for colon and rectal cancers and how screening and treatment advancements in recent years are improving the prognosis for patients.

Colorectal Cancer Stages Related to Survival Rates

The extent, or stage, of colorectal cancer is determined from biopsy results, testing of lymph nodes in the area, and images that show if the cancer has spread. Stages are indicated by Roman numerals from 0 to IV (4). The higher the number, the more your cancer has spread. 

  • Stage 0 (called carcinoma in situ) - cancer is contained in the innermost colon or rectum lining. 
  • Stage I - the tumor has grown into the inner wall of the colon or rectum but not further.
  • Stage II - the tumor has spread into or through the colon or rectum wall and possibly to nearby tissue, but not to lymph nodes.
  • Stage III - spread to nearby lymph nodes but not beyond them.
  • Stage IV - spread to distant sites, usually the liver or lungs.

Localized cancer, also called early-stage cancer, is typically considered stages 0-1 and sometimes 2. Stages 2 and 3 can be considered regional cancer while stage 4 is distant, or metastatic cancer.

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What are the Relative Survival Rates for Colon and Rectal Cancers?

It’s important to compare yourself to others who are in the same type and stage of cancer. You can ask your oncologist if they would consider your diagnosis to be localized, regional, or metastatic. 

According to the American Cancer Society, a relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of colon or rectal cancer is 80%, it means that people who have that cancer are, on average, about 80% as likely as people who don’t have that cancer to live for at least five years after being diagnosed.

5-year relative survival rates for colon cancer

These numbers are based on people diagnosed with cancers of the colon between 2012 and 2018.

  • Localized - 91% 5-year relative survival rate
  • Regional - 72% 5-year relative survival rate
  • Distant (Metastatic) - 13% 5-year relative survival rate

5-year relative survival rates for rectal cancer

These numbers are based on people diagnosed with cancers of the rectum between 2012 and 2018.

  • Localized - 90% 5-year relative survival rate
  • Regional - 74% 5-year relative survival rate
  • Distant (Metastatic) - 17% 5-year relative survival rate

While these are a good point of reference, they are not specific to your situation. Your prognosis, or likely outcome, will be different from others based on several key factors specific to you. Your oncologist will guide you through a recommended treatment plan and its effectiveness based on your situation.

What Else Affects Your Personal Prognosis?

In addition to the stage of cancer, your oncologist will estimate your prognosis based on other factors that are unique to your body, specific to your tumor and type of colorectal cancer, and the treatments that are available for you.

Your Personal Characteristics

  • Age at diagnosis  – generally, the younger you are, the better prognosis you’ll have.
  • Overall health and if you have other diseases or conditions that could hamper your body’s ability to fight cancer. 
  • Genetic factors, family history of cancer, and your race can also affect your prognosis. Learn more about whether colon cancer is genetic in our blog.

Tumor Characteristics

  • Size and location of tumor. A large tumor that’s located in a difficult area to reach with surgery will require different treatments compared to a smaller, easier to reach polyp.
  • The grade of cancer. The grade describes the appearance of your cancer cells under a microscope. The more normal the cells appear, the lower the grade of cancer. The lower the grade, the better your prognosis.
  • Mutations at the molecular level can influence your treatment options. Some colon cancers are fueled by DNA mutations to the MSI-H or BRAF genes. Targeted therapies specific to this have been developed to target DNA mutation and slow the growth of cancer cells. 
  • Type of colon cancer. There are several types of colon cancer with adenocarcinoma being the most common. The type of colon cancer impacts the treatments and the patient’s prognosis.

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Your Personal Response to Treatments

The type of treatment you receive and your body’s response to treatment are also considered when estimating prognosis. Some patients don’t respond well to the usual chemotherapy, FOLFOX, used for colon cancer. Switching to other types of chemotherapy can impact your prognosis. 

Finding Colorectal Cancer Early Improves Your Prognosis

When colon cancer is diagnosed early, you have the best prognosis. There is a high chance for a complete recovery. Screenings and follow-up appointments after cancer treatment can reduce the chance of cancer returning, either in the colorectal area or if colon cancer spreads to distant parts of your body. 

The frequency of screenings varies depending on your age, race, history of cancer, overall health, and if you have specific risk factors for colon cancer, such as a personal or family history of colon or other cancers. 

The Prognosis for Colorectal Cancer Patients Continually Improves With the New Treatments and Clinical Research

Over the past 40 years, significant advances have been made in the effectiveness of screening tools and treatments. More effective treatments using immunotherapy, targeted therapies, and different combinations of existing treatments are being tested in clinical trials.  

Targeted therapy is a category of drugs for colorectal cancer patients that has advanced greatly in the past 10 years. Biomarker tests are performed on the cancer cells to see if there is a specific genetic mutation present. There are several gene mutations in colon cancer that can now be targeted with new drug therapies to slow the growth of colorectal cancer. This personalized approach to colon cancer treatment has improved the results for many patients with more targeted therapies currently being researched.  

Colon and Rectal Cancer Treatment in Colorado 

The latest in personalized colorectal cancer treatments are available to patients in Colorado through Rocky Mountain Cancer Centers. This includes access to clinical research trials that bring the most recent advancements in colon and rectal cancer treatments to our patients.

Feel free to discuss your personal prognosis when talking to the RMCC colorectal cancer specialist. They will review all of these characteristics and your treatment goals to create a personalized treatment plan. 

Our cancer centers are located in Denver, Boulder, Colorado Springs, and throughout the Front Range.

Find a Colorectal Cancer Specialist

Find a Colorectal Cancer Specialist

Meera Patel, MD

Radiation Oncologist

Aurora, CO

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Joshua Gruhl, MD

Radiation Oncologist

Thornton, CO

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Allen L. Cohn, MD

Medical Oncologist / Hematologist

Denver, CO

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David J. Andorsky, MD

Medical Oncologist / Hematologist

Boulder, CO

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Charles Leonard, MD

Radiation Oncologist

Littleton, CO

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