Colon cancer that has been diagnosed as Stage 3, is typically categorized into one of three subcategories referred to as:
- Stage 3A (T1 – T2, N1, M0 or T1, N2a, M0)
- Stage 3B (T3 – T4a, N1, M0 or T2-T3, N2a, M0 or T1 – T2, N2b, M0)
- Stage 3C (T4a, N2a, M0 or T3-T4a, N2b, M0 or T4b, N1-N2, M0)
These stages describe exactly how far the cancer has spread through the layers of the colon and how many nearby lymph nodes also contain cancer.
Since in Stage 3 colon cancer, the cancer has spread to nearby lymph nodes, but not yet to other parts of the body surgery is recommended followed by chemotherapy. The most common chemotherapy regimen given to treat Stage 3 colon cancer is called FOLFOX (a triple combination of three agents including 5-FU, leucovorin and oxaliplatin).
Depending on the overall health of the patient other chemotherapy regimens also may be used including 5-FU and leucovorin combination treatment (without oxaliplatin), or a drug called capecitabine, which is usually given alone. Radiation therapy also may be recommended in order to kill any remaining cancer cells after surgery.
About Staging
The stage of colon cancer at diagnosis, or the extent to which it is present in the body, is typically determined by a staging system developed by the American Joint Committee on Cancer (AJCC) called the TNM System. Determining the stage of the colon cancer is one of the most vital factors in determining the most appropriate treatment options.
The AJCC TNM system evaluates the tumor based on the following criteria:
- T Category
- Describes the size of the primary tumor, which is measured in centimeters. The colon consists of several layers that form the wall of the colon, so it is important to know the extent of the growth into the wall of the intestine.
- N Category
- Whether or not the colon cancer has spread to nearby lymph nodes.
- M Category
- Describes the absence or presence of distant metastasis, or spread of the cancer, to other organs.
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