Untreated colon cancer may spread rapidly to other areas, and life expectancy for some people may be lower compared to those who receive treatment. Surgery and chemotherapy are common treatments and are most effective in the early stages.

Colon cancer is one of the most common cancers in the United States. Treatment is available and most effective when a healthcare professional diagnoses it in its early stages.

With treatment, most people with colon cancer live at least 5 years. If left untreated, the cancer is more likely to spread to other organs, such as your liver or brain. Once it spreads to distant areas, treatment may no longer be effective.

Cancer treatment often causes several side effects. Some people may choose not to undergo treatment to avoid side effects if the cancer has already spread to distant body parts or if previous treatments haven’t been effective. Not receiving treatment may shorten the expected survival rate.

Colon cancer survival rates

Medical professionals often use a 5-year relative survival rate to estimate how likely someone is to survive a cancer. This statistic indicates the estimated percentage of people with that type of cancer who will be alive 5 years after diagnosis.

The 5-year relative survival for all stages of colon cancer in the United States from 2013–2019 was 63%.

In other words, 63 people out of every 100 who received a colon cancer diagnosis were alive 5 years later.

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Without treatment, colon cancer can progress quickly. Few studies have examined how fast untreated colon cancer progresses due to ethical concerns.

As per a 2020 study, among 43 diagnoses of colon cancers, tumors doubled in size after an average of 211 days. Other studies reported colon tumors growing in a period ranging from 18–2,593 days.

Stage 1 to 3 colon cancer

A 2021 study reports the outcomes of 7,152 people with potentially treatable colon cancer in stages 1 to 3 who declined surgery. Half of the people who didn’t go through surgery lived less than 6.8 months compared to an average 24-month survival rate among people who received surgery.

In a 2020 study, researchers examined the outlooks of 407 people in their 80s and 90s with colon cancer that hadn’t yet spread to distant body parts. Of these people, 132 received palliative treatments, and 275 underwent surgery. Palliative means the treatment aims to minimize symptoms and prolong life but not to cure the cancer.

The researchers found an overall:

  • 2-year survival rate of 38.9% in people who didn’t receive surgery compared to 78.9% in people who received surgery
  • 5-year survival rate of 11.3% in people who didn’t receive surgery compared to 59.6% in people who received surgery

Stage 4 cancer

Colon cancer is called stage 4 or metastatic cancer if it spreads to distant body parts. Stage 4 cancer isn’t generally considered curable, so treatment is usually palliative.

Palliative treatment may increase the survival time of people with stage 4 colon cancer by up to 20 months.

Treatment for colon cancer may potentially improve the chances of surviving it or prolong survival. Here’s a look at the 5-year relative survival rates of colon cancer in the United States from 2013–2019:

StageDescriptionSurvival rate
LocalizedCancer is limited to colon91%
RegionalCancer has spread to nearby tissues73%
DistantCancer has spread to distant body parts13%
All stagesAll stages combined63%

Here’s a look at the common treatments for each stage of colon cancer.

Stages 1 and 2

The treatment for stage 1 and 2 colon cancer is typically two types of surgery called resection and anastomosis. Resection involves removing parts of your bowel, and anastomosis aims to reconnect the remaining segments.

Chemotherapy isn’t usually added to the plan, but researchers are currently investigating whether it may improve survival after surgery.

Learn more about surgery for colon cancer.

Stage 3

The treatment for stage 3 colon cancer is often resection and anastomosis and may be followed with chemotherapy.

Stage 4 or recurrent cancer treatment

Stage 4 colon cancer treatment is usually palliative.

At this stage, your doctor may recommend newer treatments such as targeted therapy or immunotherapy.

Targeted therapy is a non-chemotherapy option that specifically targets certain proteins in cancer cells. It may cause fewer or different side effects compared to chemotherapy. Immunotherapy drugs stimulate your immune system to protect your body against cancer cells.

Stage 4 or recurrent colon cancer may be treated with the following:

  • surgery to remove tumors
  • surgery to remove parts of organs such as lungs, liver, or ovaries
  • radiation therapy or chemotherapy as palliative therapy
  • targeted therapy
  • immunotherapy
  • clinical trial of new chemotherapy or targeted therapies

If colon cancer is left untreated, it will likely continue to grow larger. Eventually, it may lead to death as your vital organs shut down.

Large tumors are more likely to cause symptoms, which might include:

Large tumors might also lead to a partial or complete bowel obstruction. Bowel obstruction is a medical emergency that may cause:

  • severe pain
  • abdominal bloating
  • vomiting
  • inability to pass gas or stool
  • severe cramping

The cancer can eventually grow into tissues near your colon, such as lymph nodes or blood vessels. Cancer cells can travel through these systems to distant parts of your body, such as:

  • liver
  • brain
  • lungs
  • distant lymph nodes
  • the lining of your abdominal cavity (peritoneum)

Spread to distant locations can cause other symptoms such as:

What are the odds of healing from colon cancer?

Recovery from colon cancer improves the earlier you receive a cancer diagnosis and treatment. People with cancer limited to their colon survive for at least 5 years, about 91% as often as people without colon cancer.

Can you survive colon cancer without chemotherapy?

Chemotherapy is generally one of the main treatments for advanced colon cancers. You may not need chemotherapy to treat stage 1 or 2 cancer.

Is remission possible with stage 4 colon cancer?

In rare cases, remission is possible with stage 4 colon cancer. In a 2020 study, researchers presented a case of a 44-year-old woman with cancer that spread to her lungs and liver. She entered complete remission. Her healthcare team treated the tumors in her liver before surgically removing the tumor in her colon and lungs. She had no sign of reoccurrence 3 years later at the time of publication.

Colon cancer is one of the most common cancers in the United States. Without treatment, colon cancer may quickly spread to other body parts. With early diagnosis and treatment, remission is possible in many cases. Remission for stage 4 cancer is rare but still possible.