Treating Stage 3 Colorectal Cancer

Following your colorectal cancer diagnosis, your team of doctors will begin to advise you on the treatment options that are available, and which are most suitable for your diagnosis. Depending on your stage, cancer/tumor type and genetics, some treatments may be more or less effective than others, and having a better understanding of what to expect can help you make more informed decisions.

In this series of articles, we cover the treatment that you may be recommended based on the cancer stage when you are diagnosed. We hope this helps you keep a positive mindset while preparing for the next phase of your journey with cancer.

This article will outline and explain the available and likely treatments for stage 3 colorectal cancer.

Stage 3 colorectal cancer, based on the American Joint Committee on Cancer (AJCC) TNM system, is when cancer has spread from the inner lining and penetrated the intestinal wall, and also spread to the lymph nodes.

The subtypes of stage 3 colorectal cancer are dependent on how many lymph nodes it has spread to. As shown in the image below, the cancer is considered at stage 3A if it has spread to the muscle layers and 1 to 3 nearby lymph nodes, OR if it has spread to 4 to 6 nearby lymph nodes and grown into the submucosa but not the muscle layer.

Stage 4 cancer, on the other hand, is more advanced, such that cancer has spread from the colon to distant organs such as the lungs, the cancer spread in stage 3 is limited to the lymph nodes found along the colon, as well as the nearby organs.

The standard treatment for this stage, as indicated by the American Society of Clinical Oncology and the National Comprehensive Cancer Network, typically consists of a surgical procedure known as partial colectomy, which involves the removal of the cancerous section of the colon along with adjacent lymph nodes. Following surgery, adjuvant chemotherapy is administered.

In terms of chemotherapy, two common regimens are frequently used:

• FOLFOX (comprising of folinic acid, fluorouracil and oxaliplatin)
• CapeOx (consisting of capecitabine and oxaliplatin)

However, the choice between these regimens or the use of fluorouracil with folinic acid or capecitabine alone may depend on your age and specific health requirements.

Stage 3 colorectal cancer is a complex disease with many different possible treatment combinations. This article aims to provide information on the recommended treatment options for this stage, but it is important to note that your plan will be unique to your cancer, and the most reliable and accurate information will come from the cancer care team. Having prior knowledge of these treatments can help you better understand the advice of the cancer care team and engage in more open communication with them.