Stage 3 bowel cancer

About stage 3 bowel cancer

Stage 3 bowel (colon and rectal) cancer has spread to nearby lymph nodes, but hasn't spread to distant body parts. It's divided into 3 groups - 3A, 3B and 3C.

Stage 3A

Stage 3A means one of the following:

• the cancer is still in the inner or muscle layer of the bowel wall, and it has spread to between 1 to 3 nearby lymph nodes or to areas of tissue close to the lymph nodes

• the cancer is in the inner layer of the bowel wall and has spread to between 4 and 6 nearby lymph nodes

Stage 3B

Stage 3B means one of the following:

• the cancer has grown into the outer lining of the bowel wall or into the tissue layer covering the organs in the tummy (abdomen) and it has spread to between 1 and 3 nearby lymph nodes or to areas of fat close to the lymph nodes

• the cancer has grown into the muscle or outer lining of the bowel wall and between 4 to 6 nearby lymph nodes contain cancer

• the cancer is still in the inner or muscle layer of the bowel wall and it has spread to 7 or more nearby lymph nodes

Stage 3C

Stage 3C means one of the following;

• the cancer has grown through the outer lining of the bowel wall into the tissue layer covering the organs in the tummy (abdomen) and between 4 to 6 nearby lymph nodes contain cancer

• the cancer has grown into the outer lining of the bowel wall or into the tissue layer covering the organs in the abdomen and it has spread to 7 or more nearby lymph nodes

• the cancer has grown through the bowel wall into other nearby organs and it has spread to at least one nearby lymph node or to areas of fat close to the lymph nodes

TNM stages

The TNM staging system stands for Tumour, Node, Metastasis.

In TNM staging stage 3A is one of the following:

• T1 - T2, N1 - N1c, M0

• T1, N2a, M0

In TNM staging, stage 3B is one of the following:

• T3 - T4a, N1 - N1c, M0

• T2 - T3, N2a, M0

• T1 - T2, N2b, M0

In the TNM staging, stage 3C is the same as one of the following:

• T4a, N2a, M0

• T3 - T4a, N2b, M0

• T4b, N1 - N2, M0

Find out about the TNM system

Treatment for stage 3 large bowel (colon) cancer

You have surgery to remove your cancer.

Your surgeon might suggest ​chemotherapy​ before or after surgery.

Chemotherapy before surgery can shrink the cancer to make it easier for to remove. Chemotherapy after surgery can lower the chance of your cancer coming back after surgery.

You might be offered your chemotherapy treatment as part of a ​clinical trial.

Read more about treatment for colon cancer

Treatment for stage 3 cancer of the back passage (rectal cancer)

The main treatments are:

• surgery

• radiotherapy

• chemotherapy

• chemotherapy combined with radiotherapy (chemoradiotherapy)

You might have:

• surgery as your only treatment

• a short course of radiotherapy, followed by surgery

• a course of chemoradiotherapy, followed by surgery

• a course of chemotherapy, followed by surgery

• total neoadjuvant therapy (TNT) – this might be chemoradiotherapy and a course of chemotherapy all before surgery

Further treatment

Your doctor might offer you chemotherapy after surgery. This might be if tests on your cancer after surgery show there is a high risk of it coming back. You're more likely to have chemotherapy after surgery if you did not have it before surgery.

Read more about treatment for rectal cancer

Other stages

• Stage 1

• Stage 2

• Stage 4