Stage III

What is stage III colorectal cancer?

Stage III colorectal cancer has spread into nearby lymph nodes, but has not reached other areas of the body.

Colon cancer

Stage III colon cancer is divided into three categories.

- The cancer has spread through the innermost layer (mucosa) of the colon wall to the layer next to the mucosa (submucosa) or to the muscle layer of the colon wall.
- It has also spread into one to three nearby lymph nodes or into tissue near the lymph nodes.
OR
- The cancer has spread through the innermost layer (mucosa) of the colon wall to the layer next to the mucosa (submucosa).
- It has also spread to four to six nearby lymph nodes.
- The cancer has spread through the through the muscle layer of the colon wall to the outermost layer (serosa) of the colon wall or has spread through the outermost layer to the tissue that wraps around the organs in the abdomen (visceral peritoneum).
- It has also spread to one to three nearby lymph nodes or into tissue near the lymph nodes.
OR
- The cancer has spread through the muscle layer or to the outermost layer (serosa) of the colon wall.
- It has also spread to four to six nearby lymph nodes.
OR
- The cancer has spread through the innermost layer (mucosa) of the colon wall to the layer of tissue next to the mucosa (submucosa) orto the muscle layer of the colon wall.
- It has also spread to seven or more nearby lymph nodes.
- The cancer has spread through the outermost layer (serosa) of the colon wall to the tissue that wraps around the organs in the abdomen (visceral peritoneum).
- It has also spread to four to six nearby lymph nodes.
OR
- The cancer has spread through the muscle layer of the colon wall to the outermost layer (serosa) of the colon wall or has spread through the outermost layer to the tissue that wraps around the organs in the abdomen (visceral peritoneum).
- It has also spread to seven or more nearby lymph nodes.
OR
- The cancer has spread through the outermost layer (serosa) of the colon wall to nearby organs.
- It has also spread to one or more nearby lymph nodes or into tissue near the lymph nodes.

Treatment for stage III colon cancer

The standard treatment for stage III colon cancer is:

Surgery to remove the section of the colon that has cancer (partial colectomy). Your surgeon will also remove nearby lymph nodes during this procedure.
Chemotherapy:

Most often the FOLFOX (5-FU, leucovorin, and oxaliplatin) or CapeOx (capecitabine and oxaliplatin) regimens are used.

More about treatments

Radiation therapy for stage III colon cancer

Stage III colon cancer that cannot be removed completely by surgery may be treated with chemotherapy along withradiation therapy to shrink the cancer so it can be removed later with surgery.

Radiation therapy may also be used for stage III cancer after surgery because:

The cancer was attached to a nearby organ.

The tissue that was removed had positive margins (cancer was found in the edges of the area left behind).

More about radiation therapy

Rectal cancer

Stage III rectal cancer is divided into three categories.

- The cancer has spread through the innermost layer (mucosa) of the rectal wall into the layer of tissue next to the mucosa (submucosa) orinto the muscle layer of the rectum wall.
- It has also spread to one to three nearby lymph nodes or into tissue near the lymph nodes.
or
- The cancer has spread through the innermost layer (mucosa) of the rectal wall into the layer of tissue next to the mucosa (submucosa) or into the muscle layer of the rectum wall.
- It has also has spread to four to six nearby lymph nodes.
- The cancer has spread through the muscle layer of the rectal wall to the outermost layer (serosa) of the rectal wall or has spreadthrough the serosa to the tissue that wraps around the organs in the abdomen (visceral peritoneum).
- It has also spread to one to three nearby lymph nodes or into tissue near the lymph nodes.
OR
- The cancer has spread to the muscle layer or to the outermost layer (serosa) of the rectum wall.
- It has also spread to four to six nearby lymph nodes.
OR
- The cancer has spread through the innermost layer (mucosa) of the rectal wall to the layer of tissue next to the mucosa (submucosa) orto the muscle layer of the rectal wall.
- It has also has spread to seven or more nearby lymph nodes.
- The cancer has spread through the outermost layer (serosa) of the rectal wall to the tissue that wraps around the organs in the abdomen (visceral peritoneum).
- It has also has spread to four to six nearby lymph nodes.
OR
- The cancer has spread through the muscle layer of the rectal wall to the outermost layer (serosa) of the rectal wall or has spreadthrough the outermost layer to the tissue that wraps around the organs in the abdomen (visceral peritoneum).
- It has also has spread to seven or more nearby lymph nodes.
OR
- The cancer has spread through the outermost layer (serosa) of the rectal wall to nearby organs.
- It has also has spread to one or more nearby lymph nodes or into tissue near the lymph nodes.

Treatment for stage III rectal cancer

Stage III rectal cancer is usually treated with a combination of:

Chemotherapy

Radiation therapy

Surgery

Every person's diagnosis is different, so the order of these three treatments may vary.

Chemo & radiation

In most cases chemotherapy (usually 5-FU or capecitabine) and radiation are the first treatment. This allows the tumor to shrink in size before surgical treatment.

Surgery

Surgery is usually the second phase. Depending on where the the cancer is located in the rectum, surgeries that may be performed are:

Transanal resection

Low anterior resection (LAR)

Proctectomy

Abdominoperineal resection (APR)

If the cancer has spread to nearby organs, a surgery called pelvic exenteration may be needed.

Additional chemo

The third phase is additional chemo after surgery.

Chemo drugs may be:

FOLFOX regimen (oxaliplatin, 5-FU, and leucovorin)

5-FU and leucovorin

CAPEOX (capecitabine plus oxaliplatin)

Capecitabine alone

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