Do Different Stages of Colorectal Cancer Have Different Symptoms?

One of the most challenging aspects of colorectal cancer is identifying symptoms. Many people don't have any symptoms until the disease is advanced, or if they do, the symptoms are vague and could be attributed to any number of other conditions.

This is why it is so important to keep up with routine screening tests, such as colonoscopies, stool tests or blood tests, and to maintain communication with your doctor.

"It's a matter of paying attention to your body and noticing when something is wrong," says Dr. Monisha Singh, a gastrointestinal medical oncologist at Houston Methodist. "Then working with your health care provider to get the tests you need. And don't forget, you know your body best, so don't hesitate to advocate for yourself. If you feel that your doctor is dismissing your concerns, get a second opinion."

The symptoms of colorectal cancer can vary depending on the stage of the disease. Learn the signs so you can talk to your doctor about the possibility you have a tumor — or some other condition.

Understanding the stages of colorectal cancer

Once you are diagnosed with colon cancer, your healthcare team will work to figure out if it has spread, and if so, how far. This is called staging, and it helps decide how best to treat the cancer.

There are five stages of colon cancer, starting at zero and going up to four. Three of the stages also include substages. Generally, the lower the number, the less the cancer has spread:

• Stage 0 – The cancer is in its earliest stage and has not grown beyond the inner layer of the colon or rectum.
• Stage I – Cancer has spread into the wall of the colon or rectum but not to nearby lymph nodes or organs.
• Stage II – Cancer has spread through the thick outer muscle layer of the colon but not to nearby lymph nodes. There are three types of Stage II colon cancer, broken down by factors such as whether the cancer has spread to another organ.
• Stage III – Cancer has spread outside the colon to one or more lymph nodes. There are three types of Stage III colon cancer, broken down by the number of lymph nodes also affected and whether it has spread to another organ.
• Stage IV – Cancer has spread to other parts of the body, such as the liver, lungs or the lining of the stomach (peritoneum). It also may be in the lymph nodes. There are three types of Stage IV colon cancer, broken down by the number of organs and lymph nodes affected.

Symptoms of early-stage colorectal cancer

If you have stage 0 or stage I colorectal cancer, it's possible that you won't notice any symptoms of the disease. However, early warning signs may include:

• Changes in your bowel habits – This could include persistent constipation, diarrhea or having long, thin, pencil-like stools, as well as feeling as if you still need to evacuate your bowels even after going to the bathroom. (Related: What Your Stool Says About Your Health)
• Blood in the stool – You may notice blood in the toilet or on the toilet paper after you poop. Your poop also could appear bright red or even black.
• Stomach discomfort – This can feel like cramps, gas or even severe pain.
• Unexplained weight loss – This will be a noticeable drop that happens when you're not trying to lose weight.

(Related: 4 Colon Cancer Symptoms to Never Ignore)

Symptoms of late-stage colorectal cancer

Colon cancer that has advanced to later stages can cause severe symptoms. Signs of late-stage colon cancer include:

• Persistent stomach pain or bloating – Tumors in the colon can cause a blockage that is painful and makes it hard to fully empty your bowels, making you feel full and bloated.
• Fatigue – Feeling much more tired and lethargic than is expected can be a sign of anemia, meaning your iron count is low. Anemia can be a sign of colon cancer.
• Vomiting – This includes vomiting on and off for no known reason or vomiting a lot in 24 hours.

If the cancer has spread, you may experience additional symptoms depending on which organ it has spread to:

• Lungs – Cough that doesn't go away, chest pain and trouble breathing
• Liver – Jaundice (yellowing of the skin and eyes) and swelling of the legs
• Bones – Bone pain, broken bones, and numbness or weakness in the legs

When to see a doctor

Noticing one or more of the signs above doesn't automatically mean you have cancer. Most symptoms of colon cancer can be attributed to a number of other health issues.

Still, it's always best to check with your healthcare provider anytime you notice changes in your body, especially if they persist or worsen over several weeks. One symptom that should always trigger you to contact your doctor right away is blood in your stool.

Dr. Singh reminds people that even though colon cancer is more common after the age of 50, you shouldn't ignore symptoms if you're younger.

"Colorectal cancer is rising among people younger than 50," says Dr. Singh. "The days of saying, 'Oh, you're 32, so there's no way you have colorectal cancer,' are gone."