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Once all necessary  tests and examinations have been carried out, your oncologist will discuss  further aspects of your treatment.  This treatment  is based on the common international staging systems which take into account the spread of the cancer to other organs as well as the specific characteristics of the cancer cells, for example the TNM classification. 

The Classification of Colorectal Cancer

The process of classifying malignant tumors in cancer medicine is called 'staging'. In addition to the TNM classification, colorectal cancer is further graded in four stages identified by Roman numerals (I, II, III or IV). Stage I represents the earliest malignant development phase, stage IV the most advanced phase.

More information on staging and the TNM system can be found in the link to the UICC Classification.

Your treatment at CIO follows national and international standards and clinical practice guidelines. This standard is, metaphorically speaking, comparable to a corridor from which many doors open to the separate therapeutic pathways for the duration of your treatment. Your treatment will be tailored to your medical condition and adjusted to your personal situation. Moreover, each step along the treatment corridor is discussed at length and explained fully to you and your relatives by our experts. CIO experts provide ample time for you to make decisions and are always available for advice and support through your entire treatment at CIO.

For more detailed information on the available treatment options, please select from the following menu:

• Colon Cancer Stage I-III
• Rectal Cancer Stage I-III
• Colorectal Cancer Stage IV

Colon Cancer Stage I - III

The tumor is locally restricted and staged according to its size. In stage III, the surrounding lymph nodes are also affected.

Treatment: The paramount therapeutic goal is always the complete operative removal of the malignant tumor. Following an operation of tumor stages I and II, you will be  discharged into the regular after care programme. With tumors of stage II, adjuvant chemotherapy may be added post operatively in stage II (e.g. if the tumor has broken through the abdominal wall or is constricting the intestine). In stage III, we always recommend adjuvant chemotherapy after the operation.
The treatment of colon cancer in stages I-II is depicted in the following simplified flow diagram: Please click here Klicken Sie hier für den weiteren Ablaufplan Ihrer Behandlung im CIO

Rectal Cancer Stage I - III

In the case of rectal cancer stage I - II the tumor is locally restricted, e.g. in  part of the intestine, and is staged according to its size. In stage III, the surrounding lymph nodes are also affected (lymph node metastases).

Treatment: First line therapy of rectal cancer is surgery. The whole intestine affected by the tumor, as well as part of the intestine adjacent to the tumor-affected area and the lymph drainage area, together with its corresponding lymphatic vessels and lymph nodes are completely removed. According to CIO treatment standards, stage II and III rectal cancer receives preoperative  chemotherapy as well as tumor irradiation to reduce the tumor size and to lower the risk of developing new malignancies in the same location (local recurrence). These treatment interventions improve the chances of surgical success.
The treatmen of rectal cancer in stage I-II is illusratedin the following simplified flow diagram: Please click here Klicken Sie hier für den weiteren Ablaufplan Ihrer Behandlung im CIO

Colorectal Cancer Stage IV

Treatment: The treatment of advanced stage IV disease comprises chemotherapy as well as antibody therapy. A range of therapeutic combinations is available and your oncologist will select a combination which is suitable for your clinical condition. In the case of liver metastases that cannot be surgically removed in the first instance, these may be operated on following  treatment with chemotherapy. In advanced disease, all our therapeutic efforts aim to slow down metastatic spread and to help you maintain a good quality of life.

If there is a history of colorectal cancer in your family, you might want to find out whether your risk to develop this cancer is increased. The CIO Bonn campus offers a consultation service for those affected by familial colorectal cancer. Appointments can be made here:

FAP-/HNPCC-Consultation hours (by appointment only)

Sigmund-Freud-Str. 25
53105 Bonn-Venusberg
Phone: +49 228 / 287-15332
Fax:      +49 228 / 287-16887
cio[at]ukb.uni-bonn.de