Colorectal Cancer Stage III

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Stage III Colorectal Cancer

Stage III colorectal cancer is further divided into three more separate categories: IIIA, IIIB and IIIC. The difference between the categories lies in the extent to which the cancer has spread, and how many lymph nodes have been affected.

Stage IIIA Colorectal Cancer: The cancer has grown into the submucosa. It may have also grown into the muscularis propria. The cancer has spread to 1 – 3 lymph nodes near the site of the primary tumor, but has not spread to distant sites.
Stage IIIB Colorectal Cancer: The cancer has grown into the outermost layer of the colon or rectum, but has not reached nearby organs. Or, it has grown through the wall of the colon or rectum and into nearby organs or tissues. The cancer has spread to 1 – 3 lymph nodes near the primary site, but has not spread to distant organs.
Stage IIIC Colorectal Cancer: The cancer may or may not have grown through the wall of the colon or rectum, but has spread to four or more lymph nodes near the primary site. The cancer has not metastasized to distant sites.

The difference between colon cancer and rectal cancer is the location where the tumor originates, be it the colon or rectum. Since the two types of cancer are similar, they are often both referred to as simply colorectal cancer.

The survival rate for patients with colorectal cancer in stage III depends on how far the disease has spread at the time of diagnosis. Additionally, stage III usually indicates some lymph node involvement, which will have an effect on the overall prognosis. The five-year survival rate for stage III colorectal cancer ranges from 35 -75 percent, depending on an A, B or C diagnosis.

TNM Categories

Stage IIIA colorectal cancer can be staged in two different ways using the TNM scale:

T1- T2: If the cancer has grown into the submucosa it is considered T1. Cancer that has grown into the muscularis propria is categorized as T2.
N1a- N1b: The cancer has spread to 1 – 3 nearby lymph nodes. N1a indicates 1 lymph node, while N1b indicates 2 – 3.
M0: The cancer has not spread to distant organs.

T1: The cancer has grown into the submucosa.
N2a: The cancer spread to 4 – 6 nearby lymph nodes.
M0: The cancer has not spread to distant organs.

Stage IIIB can be represented in three different ways using the TNM scale:

T3-T4a: The cancer has grown through the muscularis propria and into the outermost layers of the colon or rectum, but not all the way through them (T3). Or, the cancer has grown through the visceral peritoneum, the outermost lining of the intestines (T4a).
N1a- N1b: The cancer has spread to 1 – 3 nearby lymph nodes. N1a indicates 1 lymph node, while N1b indicates 2 – 3.
M0: The cancer has not spread to distant organs.

T2-T3: The cancer has grown through the submucosa (T2), or the cancer has grown through the muscularis propria and into the outermost layers of the colon or rectum, but not all the way through them (T3).
N2a: Cancer cells have been located in 4 – 6 lymph nodes in the nearby region.
M0: The cancer has not spread to distant organs.

T1-T2: If the cancer has grown into the submucosa it is considered T1. Cancer that has grown into the muscularis propria is categorized as T2.
N2b: Cancer cells have been located in more than 7 lymph nodes in the nearby region.
M0: The cancer has not spread to distant organs.

Stage IIIC colorectal cancer can be represented in three different ways using the TNM scale:

T4a: The cancer has grown through the visceral peritoneum, the outermost lining of the intestines.
N2a: Cancer cells have been located in 4 – 6 lymph nodes in the nearby region.
M0: The cancer has not spread to distant organs.

T3-T4a: The cancer has grown through the muscularis propria and into the outermost layers of the colon or rectum, but not all the way through them (T3). Or, the cancer has grown through the visceral peritoneum, the outermost lining of the intestines (T4a).
N2b: Cancer cells have been located in more than 7 lymph nodes in the nearby region.
M0: The cancer has not spread to distant organs.

T4b: The cancer has grown through the wall of the colon or rectum and has extended into nearby tissues or other organs.
N1-N2: It has spread to at least 1 lymph node, but no more than 6.
M0: The cancer has not spread to distant organs.

What Is Stage III Colorectal Cancer?

Many cases of colorectal cancer will have no symptoms. This is especially true of the earlier stages of the disease. However, the following symptoms below could be an indication of colon or rectal cancer.

Abdominal pain
Blood in the stool
Diarrhea, constipation or a change in bowel habits
Narrow stools
Unexplained weight loss

NOTE: These symptoms may be attributed to a number of conditions other than cancer. It is important to consult with a medical professional for an accurate diagnosis.

Colorectal cancer screening is recommended for people over the age of 50 and for those who have risk factors for developing the disease, such as a family history of colorectal cancer or inflammatory bowel disease. Most colorectal cancers begin as a polyp (a growth of tissue that develops in the lining of the colon or rectum). Screening tests, such as a flexible sigmoidoscopy or colonoscopy, enable doctors to check for colorectal polyps and abnormalities in the colon and rectum.

With proper screening, colorectal cancer can be detected early, which can lead to more positive treatment results.

Stage III Colorectal Cancer Treatment

Since stage III colorectal cancer indicates that the cancer has started to spread, patients usually require more treatment than just surgery to stop metastases to other organs and reoccurrence.

For patients with stage III colorectal cancer, treatment options at Cancer Treatment Centers of America (CTCA) include the following:

Resection: During this process, the doctor removes the cancer and limited amounts of surrounding healthy tissue. The healthy parts are then sewn together so that the bowel can still function normally.

Laparoscopic Surgery: Also known as minimally invasive surgery or keyhole surgery, in this innovative surgical technique a small incision is created, and then a laparoscope is inserted into the area where the surgery will take place. The laparoscope allows cameras to display enlarged images of the surgical process on TV monitors. The abdomen is usually “blown up” so that the abdomen wall is elevated to allow for a larger viewing space. The smaller incision can be beneficial in terms of less hemorrhaging, shorter recovery time and reduced pain.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC): This is one of the most innovative treatments available today for complex abdominal cancers such as advanced colorectal cancer. HIPEC is a heated, sterilized chemotherapy solution which is delivered directly to the abdomen during a surgical procedure. HIPEC is a treatment option for people who have advanced surface spread of cancer within the abdomen, without disease involvement outside of the abdomen. It may be particularly helpful for patients with abdominal tumors that have not spread to organs such as the liver or lungs, or to lymph nodes outside of the abdominal cavity.

Chemotherapy: This treatment is often recommended if your doctor thinks the cancer might return, or if there is a concern about whether or not the cancer has indeed spread to the lymph nodes.

External Beam Radiation Therapy (EBRT): This type of radiation therapy directs a beam of radiation from outside your body at cancerous tissues within your body. EBRT delivers high-energy rays to tumors, using a special X-ray machine called a linear accelerator. This machine allows radiation to be delivered from any angle and shapes radiation beams to the contour of the tumor.

Clinical Trials: Many clinical trials are open to patients with stage III colorectal cancer. Enrolling in a clinical trial may give you access to new therapies. Your doctor can provide information about ongoing studies that may be available to you.

All of our doctors and other clinicians who form your dedicated CTCA care team will work with you to develop and implement an individualized treatment plan tailored to your specific diagnosis, personal needs and preferences. Your care team will provide encouragement, support and compassion throughout your colorectal cancer treatment.