Staging of small bowel cancer
The stage of small bowel cancer describes its size and whether it has spread.
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What is staging?
The stage of small bowel cancer (also called small intestine cancer) describes its size and whether it has spread. Knowing the stage of the cancer helps doctors decide on the best treatment for you.
Cancer can spread in the body, either in the bloodstream or through the lymphatic system. Your doctors will usually check the lymph nodes close to the small bowel to help find the stage of the cancer.
There are different systems for staging small bowel cancer. The system your doctor uses will depend on the type of small bowel cancer you have. The TNM staging system is the most commonly used system for adenocarcinoma of the small bowel. TNM stands for tumour, node and metastases. We explain what this means below.
We have separate information about:
We understand that waiting to know the stage and grade of your cancer can be a worrying time. We are here if you need someone to talk to. You can:
- call the Macmillan Support Line for free on 0808 808 00 00
- chat to our specialists online
- visit our bowel (colon and rectal) cancer forum to talk to people who have been affected by bowel cancer, share your experience, and ask an expert your questions
- visit our duodenal cancer forum to talk to people who have been affected by cancer of any part of the small bowel, or small intestine.
TNM staging system
T – describes how far the tumour has grown into the wall of the small bowel, and whether it has grown into nearby tissues or organs.
N – describes whether the cancer has spread to the lymph nodes.
M – describes whether the cancer has spread to another part of the body, such as the liver or lungs. This is called secondary or metastatic cancer.
T – Tumour
The small bowel wall is made up of layers of different tissues.
Tis means the cancer is at its earliest stage (in situ). It is growing into the top layers of the mucosa but no further. The mucosa is a layer of tissue that covers the inside of the small bowel.
- T1 means the tumour is only in the inner layer of the small bowel. This layer is called the submucosa.
- T2 means the tumour has grown into the muscle layer of the small bowel wall but no further.
- T3 means the tumour has grown through the muscle layer into the next layer (the subserosa). This layer is between the muscle and outer layer of the small bowel wall.
- T4 means the tumour has grown into the outer layer of the bowel wall (the serosa). It may also be growing into the surrounding organs, such as the large bowel, bladder, stomach or pancreas.
N – Nodes
- N0 means no lymph nodes contain cancer cells.
- N1 means there are cancer cells in 1 or 2 nearby lymph nodes.
- N2 means there are cancer cells in 3 or more nearby lymph nodes.
M – Metastases
- M0 means the cancer has not spread to other organs.
- M1 means the cancer has spread to other organs, such as the liver or lungs.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our small bowel cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
AB Benson, AP Venook, MM Al-Hawary et al. Small Bowel Adenocarcinoma, Version 1.2020, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network, 17(9), 1109-1133. Available from: www.jnccn.org [accessed January 2023].
National Institute for Health and Care Excellence (NICE). Wireless capsule endoscopy for investigation of the small bowel. Published: 15 December 2004. Available from: www.nice.org.uk/guidance/ipg101 [accessed January 2023].
Date reviewed
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