Stage 3 anal cancer

Stage 3 anal cancer means the cancer hasn't spread to distant parts of the body. But it can be any size, and it also one of the following:

  • growing into nearby organs such as the vagina Open a glossary item, urethra Open a glossary item or bladder Open a glossary item
  • has spread to the nearby lymph nodes Open a glossary item
  • has both grown into nearby organs and spread to nearby lymph nodes

Stage 3 is divided into 3 groups. These are 3A, 3B and 3C. 

Anal cancer can start in different cell types. This information is for squamous cell cancer Open a glossary item which is the most common type of anal cancer.

TNM staging

Doctors also use another staging system for anal cancer. They call this the TNM staging system. It stands for tumour, node and metastasis: 

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the nearby lymph nodes
  • M describes whether the cancer has spread elsewhere in the body

The TNM system describes the cancer in detail. The number staging system puts these details together to give an overall stage. 

Stage 3A

This means the cancer is no bigger than 5cm. And has spread to nearby lymph nodes in the rectum, pelvis or the groin. But it hasn't spread to other parts of the body.

Number stage 3A is the same as the TNM stages:

  • T1, N1, M0  
  • T2, N1, M0
Diagram showing stage 3a anal cancer

Stage 3B

This means the cancer is any size and is growing into the surrounding organs, such as the:

  • bladder
  • urethra
  • vagina

The cancer hasn't spread to the nearby lymph nodes or any other parts of the body. 

Number stage 3B is the same as T4, N0, M0 in the TNM staging system.

Diagram showing stage 3b anal cancer

Stage 3C

This means the cancer has spread to the nearby lymph nodes but not to other parts of the body.

The cancer can be larger than 5cm, but hasn't grown into the surrounding organs, such as the urethra, vagina or bladder.

This is the same as TNM stage T3, N1, M0.

Diagram showing stage 3C anal cancer that is larger than 5cm and has spread to nearby lymph nodes

Stage 3C can also mean a cancer of any size that has grown into organs such as the urethra, vagina or bladder, as well as the nearby lymph nodes.

This is the same as TNM stage T4, N1, M0.

Diagram showing stage 3C anal cancer that has spread to nearby organs and lymph nodes

Your doctor will explain how big the cancer is and if it has spread to the surrounding organs.

Treatment for stage 3 anal cancer

Knowing the stage of the cancer helps your doctor decide which treatment is best for you. Treatment can also depend on:

  • where the cancer is in your anus
  • your general health

Chemoradiotherapy

The main treatment for stage 3 anal cancer is chemoradiotherapy. This means you have both:

  • chemotherapy
  • radiotherapy

Chemotherapy uses anti cancer drugs to destroy cancer cells. These drugs are also called cytotoxic drugs. They circulate throughout the body in the bloodstream. Radiotherapy uses high energy waves similar to x-rays to kill cancer cells.

When you have finished your treatment, your doctor will check that the cancer has completely gone.

Unfortunately, chemoradiotherapy isn't suitable for everyone. Your doctor will talk to you about other options if they feel it isn't the best treatment for you.

If your doctor thinks there are still cancer cells

If your doctor thinks there is any cancer left after chemoradiotherapy, they take a sample of tissue (biopsy) from the area. If this contains cancer cells, they will talk to you about further treatment. This may include a large operation called an abdominoperineal resection (APR). Your surgeon and anaesthetist Open a glossary item will make sure you are well enough to have this surgery.

Other stages of anal cancer

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2017

  • Anal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    S Rao and others
    Annals of Oncology, 2021. Volume 32, Issue 9, Pages 1087-1100

  • Association of Coloproctology of Great Britain & Ireland (ACPGBI): Guidelines for the Management of Cancer of the Colon, Rectum and Anus (2017) – Anal Cancer
    I Geh and others
    Colorectal Disease, 2017. Volume 19, Issue S1, Pages 82-97

  • Anal Cancer
    BMJ Best Practice
    Accessed May 2025

  • Abdominoperineal Resection
    G Menon and others
    National Library of Medicine (StatPearls)
    Accessed May 2025

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk if you would like to see the full list of references we used for this information.

Last reviewed: 
13 May 2025
Next review due: 
13 May 2028

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