About advanced bowel cancer

What is advanced bowel cancer?

Advanced bowel cancer is cancer that has spread from the bowel to other parts of the body. You may also hear it being called secondary, metastatic or stage 4 bowel cancer.  

Bowel cancer can spread when parts of the tumour break away from the bowel and travel to another part of the body. The tumour in the bowel is called the primary tumour. The tumour that is in a different part of the body is called a secondary tumour, or metastasis. The most common places for bowel cancer to spread are: 

• the liver
• the lungs
• the peritoneum (a thin layer of tissue that covers the organs in your tummy (abdomen)).

In some cases, bowel cancer can also spread to other parts of the body, such as the bones, ovaries and brain.  These cases are much rarer. Even though the cancer has spread to other parts of the body, it is still bowel cancer and the cells are still bowel cancer cells. 

Locally advanced bowel cancer

Some people may have locally advanced bowel cancer. This is when cancer has spread into tissues that are next to the bowel, such as the bladder or nearby lymph nodes. This is sometimes called stage 3 bowel cancer and is different to advanced bowel cancer. Healthcare professionals may mean slightly different things when they use advanced and locally advanced bowel cancer. If you aren't sure, ask your healthcare team to explain what they mean. 

Read more about the staging of bowel cancer. 

Signet cell cancer

Signet cell cancer is a type of cancer that usually starts in the stomach, but can start in other parts of the body including the bowel. Around 1 in 100 bowel cancer cases are signet cell cancers and these cases are more likely to be diagnosed at later stages. 

Signet cell cancer is also known as signet ring cell carcinoma (SRCC). This is because under a microscope the cancer cells look like signet rings. If more than half of the cancer cells are signet cells then the cancer is diagnosed as SRCC. 

There is no known cause for signet cell cancers, but some research suggests it could be linked to genetics or lifestyle factors like diet. 

The treatment for SRCC depends on where in the body the cancer is, or where it started. SRCC that starts in the bowel may be treated with surgery or chemotherapy, or a combination.

Krukenberg tumours

One type of signet cell cancer is a rare tumour called a Krukenberg tumour. These tumours grow on the ovaries but are not ovarian cancer. They are caused by another type of cancer, such as signet cell bowel cancer, spreading to the ovaries. Krukenberg tumours may be treated with surgery, chemotherapy or radiotherapy.  

You can speak to your healthcare team about your treatment options or contact our friendly expert colorectal nurses at [email protected] with any questions.

Updated March 2026 

Next review March 2029