Table of ContentsView AllTable of ContentsSymptomsDiagnosisStaging and GradingTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Symptoms
Diagnosis
Staging and Grading
Treatment
Prognosis
Coping
This article reviews the possible symptoms of stage 3 colon cancer and how healthcare providers go about classifying, diagnosing, and treating it. You’ll also learn about the expected outcome if you or a loved one are diagnosed with it.
Symptoms of Stage 3 Colon Cancer
While people with stage 1 and stage 2 colon cancer will often have no signs of the disease, those with stage 3 are more likely to develop noticeable symptoms.
This is not always the case, though, and depends largely on the size and location of the tumor.
Common
A tumor within the colon can cause astricture, which is narrowing of the intestinal passage. Eventually, as the tumor continues to grow, the interior space within the colon may become partially or completely blocked (bowel obstruction).
This narrowing or obstruction of the colon from the tumor can slow or prevent the normal movement of waste, fluids, and gas. As a result, symptoms like abdominal cramping or a change in bowel habits—constipationordiarrhea—may occur.
Bleeding is another potential symptom. You may notice brightred blood in your stoolorstool that looks dark brown or black.
Alternatively, your stool may look perfectly normal.
Does Blood in Stool Always Mean Cancer?
Slow bleeding from the tumor may cause a low red blood cell count (iron deficiency anemia). Anemia can make you feel unusually weak or tired and can be diagnosed with a simple blood test.
Other possible symptoms of stage 3 colon cancer include:
Rare
There are different types of colon cancer. The majority of them areadenocarcinomas, cancers that start in cells that secrete fluids like digestive juices.
The less common types of colon cancer can sometimes manifest with distinct symptoms. Among them:
Other rare forms of colon cancer, likesignet ring carcinomaand primary melanoma, are more aggressive and can rapidly progress from stage 3 tostage 4if not detected early.
Signs, Symptoms, and Complications of Colon Cancer
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If colon cancer is suspected, your healthcare provider will perform a battery of evaluations and tests, starting with a physical examination and medical history.
The findings of the physical exam are often non-specific but may reveal the following:
In addition to the physical exam and asking you about your symptoms, your healthcare provider will ask about your family history of cancer, whether you have been diagnosed withinflammatory bowel disease (IBD), and if you have any otherrisk factors for colon cancer. Based on these initial findings, other tests may be ordered.
How Colon Cancer Is Diagnosed
Lab Tests
If you are experiencing possible symptoms of colon cancer, like a change in bowel habits, your healthcare provider may recommend a screening stool test.
However, screening stool tests are not used if you are experiencing suspicious, more specific symptoms like visible blood in your stool or evidence of bleeding on a rectal exam.
Screening tests come with the possibility of a false-negative result, meaning you have colon cancer but the test says you don’t. That’s why a diagnostic colonoscopy (see below) is recommended in these cases instead. A colonoscopy can also help rule out other conditions, such asCrohn’s diseaseorulcerative colitis.
Screening stool tests include:
Besides stool tests, various blood tests may be ordered during your work-up for possible colon cancer:
Imaging Studies
Imaging scans may be performed to examine areas in the body suspicious for cancer and to see if a cancer, if present, has spread and how far.
Among them:
Colonoscopy
The most direct method of diagnosis iscolonoscopy, an outpatient procedure in which a flexible scope with a special, lighted camera is used to see inside the colon.
Colonoscopy is relatively non-invasive and typically performed undermonitored anesthesia. The scope, called a colonoscope, is not only able to navigate the intestinal passageway but can also take photos and obtain tissue samples for examination in the lab.
Most diagnostic colonoscopies can be performed within 30 to 60 minutes, not including preparation and anesthesia recovery time.
How to Prepare for a Colonoscopy
Biopsy
Abiopsy, or tissue sample, is considered the gold standard for confirming colon cancer, as it’s the only way to definitively diagnose the disease.
A biopsy is usually performed during a colonoscopy. In some cases, surgery may be required to perform a biopsy.
To obtain a biopsy during a colonoscopy, special instruments are fed through the tube of the colonoscope to pinch, cut, or electrically remove pieces of tissue. Once obtained, the sample is sent to a doctor called apathologist.
What to Expect From a Colon Biopsy
Cancer Staging
The exactstage of the colon cancercharacterizes the extent of its progression. The stage is confirmed when the tumor is surgically removed.
Numbers from 0 to as high as 5 are attached to each letter to describe the degree of involvement.
With stage 3 colon cancer, there will be a positive finding of a primary tumor and regionally affected lymph nodes, but no signs of metastasis.
The stage is further broken down into three substages—stages 3A, 3B, and 3C—with each advancing letter representing a progression of the disease.
Tumor Grade
The grading will involve the use of stains and other techniques to see how different the cancer cells look from normal cells, which is calledcell differentiation. These features can usually tell the pathologist how fast or slow the cancer is growing and whether the cancer is more or less likely to spread.
The cancer grades range from G1 to G4, with lower values representing a slower-growing tumor that is less likely to spread and higher numbers representing a more aggressive tumor that is more likely to spread.
Stage 3 colon cancer is typically treated with surgery,chemotherapy, and, in some cases,radiation therapy. The treatment plan will often require several medical specialists, including agastroenterologist, surgicaloncologist, medical oncologist, radiation oncologist, and yourgeneral physician.
Typically, your medical oncologist oversees and helps coordinate all facets of your cancer care. Your general physician confers with the specialists to manage your overall health. All are essential to your long-term health and well-being.
With treatment, many stage 3 colon cancers can be placed intoremission, meaning that the signs and symptoms of cancer will have disappeared—in some cases forever. Even if partial remission is achieved, treatment can slow the progression of the cancer.
With improved therapies and treatment protocols, people with stage 3 colon cancer are living longer than ever.
Your healthcare provider may suggestpalliative careduring the treatment phase, especially if your symptoms greatly affect your quality of life. Palliative care is specialized medical care focused on managing and providing relief from symptoms in addition to improving mental well-being during treatment.
How Colon Cancer Is Treated
Surgery
Stage 3 colon cancer is typically treated with surgical resection, in which a surgeon removes the affected part of the colon. This is called apartial colectomyor subtotal colectomy.
The colectomy may be performedlaparoscopically(with tiny “keyhole” incisions and specialized narrow equipment) or with traditionalopen surgery(when a large incision is made). The cutends of the intestines are then surgically attachedwith staples or sutures.
The number of lymph nodes removed is based on a number of factors, including how much of the tumor was removed, the location and grade of the tumor, and the age of the patient. Generally speaking, a lymph node dissection is considered adequate when at least 12 lymph nodes are taken out.
What to Know About Colorectal Surgery
Chemotherapy
Chemotherapy is typically used inadjuvant therapy, meaning that is delivered after surgery to clear any remaining cancer cells.
There are several forms of combination chemotherapy used in people with stage 3 colon cancer:
For advanced stage 3 tumors that cannot be removed completely with surgery, a course of chemotherapy along with radiation may be prescribed before surgery. This type of treatment, referred to as neoadjuvant therapy, can help shrink the tumor so that it is easier to resect.
For people with good performance status, meaning they are able to carry out daily tasks without assistance, the standard course of chemotherapy for stage 3 colon cancer is seven or eight cycles given over six months.
Why Is Combination Chemotherapy Used?
Radiation Therapy
Radiation may sometimes be used as neoadjuvant therapy, typically in tandem with chemotherapy (referred to as chemoradiation therapy).
For people who are not fit for surgery or whose tumors are inoperable, radiation therapy and/or chemotherapy may be used to shrink and control the tumor. In cases like this, a form of radiation calledstereotactic body radiotherapy (SBRT)can deliver precise beams of radiation to ensure greater tumor control.
What to Expect With Radiation Therapy
The prognosis of stage 3 colon cancer has improved enormously in the past few decades. With improved screening methods and the introduction of newer therapies, the number of deaths (mortality rate) is now nearly half of what it was in the 1990s.
Even with improved prognosis, colorectal cancer is the fourth most common cancer in the United States, accounting for nearly 150,000 new diagnoses each year and over 50,000 deaths.
By definition, stage 3 colon cancer is considered regional.
Survival rates are based solely on the extent of the disease. Data doesn’t account for other factors that can positively or negatively influence survival times, such as age, sex, cancer type, and general health cancer.
As such, the above-listed survival rates only provide a general sense of expectations.
Can You Prevent Colon Cancer?
It’s important to remember that even if colon cancer is advanced, it’s still highly treatable. To better cope with the challenges of treatment and recovery, there are several things you can do:
10 Tips for Surviving Cancer
Summary
The diagnosis of stage 3 colon cancer requires a biopsy, often performed during a colonoscopy. Treatment, which typically involves surgery and chemotherapy, depends on the stage (progression) and grade (severity) of the tumor, among other factors.
Even though the prognosis of stage 3 colon cancer is encouraging, with a five-year relative survival rate of 72%, being diagnosed with it can be a lot to digest. Seeking out support from others and staying active are often helpful coping strategies.
A Word From Verywell
Stage 3 colon cancer is not the same disease it was 20 years ago, and the outcomes are almost certain to improve as newer targeted therapies and immunotherapies increase survival times and the quality of life even in those with advanced metastatic disease.
Even if complete remission is not achieved, do not give up hope. Every case of colon cancer is different, with some people responding to certain therapies better than others. In addition to approved therapies, there are numerousclinical trialsto explore, offering a possible bridge to future treatments.
Reasons to Consider Clinical Trials
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Do I have colorectal cancer? Signs, symptoms and work-up.American Cancer Society.What is colorectal cancer?.Luo C, Cen S, Ding G, Wu W.Mucinous colorectal adenocarcinoma: clinical pathology and treatment options.Cancer Commun. 2019;39(1):13. doi:10.1186/s40880-019-0361-0Crystal JS, Korderas K, Schwartzberg D, Tizio SC, Zheng M, Parker G.Primary leiomyosarcoma of the colon: a report of two cases, review of the literature, and association with immunosuppression for IBD and rheumatoid arthritis.Case Rep Surg. 2018;2018:1-5. doi:10.1155/2018/6824643Theodorpoulos DG.Uncommon colorectal neoplasms.Clin Colon Rectal Surg. 2011;24(3):161-70. doi:10.1055/s-0031-1286000Georgios SK, Bampali AD.Colorectal cancer. In: Bustamante M, ed.Colonoscopy and Colorectal Cancer Screening - Future Directions. InTech; 2013. doi:10.5772/53524Issa IA, Noureddine M.Colorectal cancer screening: An updated review of the available options.World J Gastroenterol.2017;23(28):5086–5096. doi:10.3748/wjg.v23.i28.5086American Cancer Society.Tests to diagnose and stage colorectal cancer.National Institute of Diabetes and Digestive and Kidney Diseases.Colonoscopy.National Cancer Institute.Colorectal cancer screening (PDQ)–health professional version.National Cancer Institute.Colon cancer treatment (PDQ)–health professional version: Table 4. Definitions of TNM stages IIIA, IIIB, and IIIC.National Cancer Institute.Tumor grade.Recio-Boiles A, Cagir B.Colon cancer. In: StatPearls.Batista VL, Iglesias AC, Madureira FA, Bergmann A, Duarte RP, da Fonseca BF.Adequate lymphadenectomy for colorectal cancer: a comparative analysis between open and laparoscopic surgery.Arq Bras Cir Dig. 2015;28(2):105-108. doi:10.1590/S0102-67202015000200005Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: efficacy results of the Italian Three or Six Colon Adjuvant Trial.J Clin Oncol. 2018;36(15):1478-1485. doi:10.1200/JCO.2017.76.2187Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: Efficacy results of the Italian three or six colon adjuvant trial.JCO. 2018;36(15):1478-85. doi:10.1200/JCO.2017.76.2187Grothey A, Sobrero AF, Shields AF, et al.Duration of adjuvant chemotherapy for stage III colon cancer.N Engl J Med. 2018;378(13):1177-88. doi:10.1056/NEJMoa1713709Häfner MF, Debus J.Radiotherapy for colorectal cancer: Current standards and future perspectives.Visc Med. 2016;32(3):172-7. doi:10.1159/000446486American Cancer Society.Radiation therapy for colorectal cancer.National Cancer Institute.Cancer stat facts: Colorectal cancer.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Do I have colorectal cancer? Signs, symptoms and work-up.American Cancer Society.What is colorectal cancer?.Luo C, Cen S, Ding G, Wu W.Mucinous colorectal adenocarcinoma: clinical pathology and treatment options.Cancer Commun. 2019;39(1):13. doi:10.1186/s40880-019-0361-0Crystal JS, Korderas K, Schwartzberg D, Tizio SC, Zheng M, Parker G.Primary leiomyosarcoma of the colon: a report of two cases, review of the literature, and association with immunosuppression for IBD and rheumatoid arthritis.Case Rep Surg. 2018;2018:1-5. doi:10.1155/2018/6824643Theodorpoulos DG.Uncommon colorectal neoplasms.Clin Colon Rectal Surg. 2011;24(3):161-70. doi:10.1055/s-0031-1286000Georgios SK, Bampali AD.Colorectal cancer. In: Bustamante M, ed.Colonoscopy and Colorectal Cancer Screening - Future Directions. InTech; 2013. doi:10.5772/53524Issa IA, Noureddine M.Colorectal cancer screening: An updated review of the available options.World J Gastroenterol.2017;23(28):5086–5096. doi:10.3748/wjg.v23.i28.5086American Cancer Society.Tests to diagnose and stage colorectal cancer.National Institute of Diabetes and Digestive and Kidney Diseases.Colonoscopy.National Cancer Institute.Colorectal cancer screening (PDQ)–health professional version.National Cancer Institute.Colon cancer treatment (PDQ)–health professional version: Table 4. Definitions of TNM stages IIIA, IIIB, and IIIC.National Cancer Institute.Tumor grade.Recio-Boiles A, Cagir B.Colon cancer. In: StatPearls.Batista VL, Iglesias AC, Madureira FA, Bergmann A, Duarte RP, da Fonseca BF.Adequate lymphadenectomy for colorectal cancer: a comparative analysis between open and laparoscopic surgery.Arq Bras Cir Dig. 2015;28(2):105-108. doi:10.1590/S0102-67202015000200005Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: efficacy results of the Italian Three or Six Colon Adjuvant Trial.J Clin Oncol. 2018;36(15):1478-1485. doi:10.1200/JCO.2017.76.2187Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: Efficacy results of the Italian three or six colon adjuvant trial.JCO. 2018;36(15):1478-85. doi:10.1200/JCO.2017.76.2187Grothey A, Sobrero AF, Shields AF, et al.Duration of adjuvant chemotherapy for stage III colon cancer.N Engl J Med. 2018;378(13):1177-88. doi:10.1056/NEJMoa1713709Häfner MF, Debus J.Radiotherapy for colorectal cancer: Current standards and future perspectives.Visc Med. 2016;32(3):172-7. doi:10.1159/000446486American Cancer Society.Radiation therapy for colorectal cancer.National Cancer Institute.Cancer stat facts: Colorectal cancer.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Do I have colorectal cancer? Signs, symptoms and work-up.American Cancer Society.What is colorectal cancer?.Luo C, Cen S, Ding G, Wu W.Mucinous colorectal adenocarcinoma: clinical pathology and treatment options.Cancer Commun. 2019;39(1):13. doi:10.1186/s40880-019-0361-0Crystal JS, Korderas K, Schwartzberg D, Tizio SC, Zheng M, Parker G.Primary leiomyosarcoma of the colon: a report of two cases, review of the literature, and association with immunosuppression for IBD and rheumatoid arthritis.Case Rep Surg. 2018;2018:1-5. doi:10.1155/2018/6824643Theodorpoulos DG.Uncommon colorectal neoplasms.Clin Colon Rectal Surg. 2011;24(3):161-70. doi:10.1055/s-0031-1286000Georgios SK, Bampali AD.Colorectal cancer. In: Bustamante M, ed.Colonoscopy and Colorectal Cancer Screening - Future Directions. InTech; 2013. doi:10.5772/53524Issa IA, Noureddine M.Colorectal cancer screening: An updated review of the available options.World J Gastroenterol.2017;23(28):5086–5096. doi:10.3748/wjg.v23.i28.5086American Cancer Society.Tests to diagnose and stage colorectal cancer.National Institute of Diabetes and Digestive and Kidney Diseases.Colonoscopy.National Cancer Institute.Colorectal cancer screening (PDQ)–health professional version.National Cancer Institute.Colon cancer treatment (PDQ)–health professional version: Table 4. Definitions of TNM stages IIIA, IIIB, and IIIC.National Cancer Institute.Tumor grade.Recio-Boiles A, Cagir B.Colon cancer. In: StatPearls.Batista VL, Iglesias AC, Madureira FA, Bergmann A, Duarte RP, da Fonseca BF.Adequate lymphadenectomy for colorectal cancer: a comparative analysis between open and laparoscopic surgery.Arq Bras Cir Dig. 2015;28(2):105-108. doi:10.1590/S0102-67202015000200005Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: efficacy results of the Italian Three or Six Colon Adjuvant Trial.J Clin Oncol. 2018;36(15):1478-1485. doi:10.1200/JCO.2017.76.2187Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: Efficacy results of the Italian three or six colon adjuvant trial.JCO. 2018;36(15):1478-85. doi:10.1200/JCO.2017.76.2187Grothey A, Sobrero AF, Shields AF, et al.Duration of adjuvant chemotherapy for stage III colon cancer.N Engl J Med. 2018;378(13):1177-88. doi:10.1056/NEJMoa1713709Häfner MF, Debus J.Radiotherapy for colorectal cancer: Current standards and future perspectives.Visc Med. 2016;32(3):172-7. doi:10.1159/000446486American Cancer Society.Radiation therapy for colorectal cancer.National Cancer Institute.Cancer stat facts: Colorectal cancer.
American Cancer Society.Do I have colorectal cancer? Signs, symptoms and work-up.
American Cancer Society.What is colorectal cancer?.
Luo C, Cen S, Ding G, Wu W.Mucinous colorectal adenocarcinoma: clinical pathology and treatment options.Cancer Commun. 2019;39(1):13. doi:10.1186/s40880-019-0361-0
Crystal JS, Korderas K, Schwartzberg D, Tizio SC, Zheng M, Parker G.Primary leiomyosarcoma of the colon: a report of two cases, review of the literature, and association with immunosuppression for IBD and rheumatoid arthritis.Case Rep Surg. 2018;2018:1-5. doi:10.1155/2018/6824643
Theodorpoulos DG.Uncommon colorectal neoplasms.Clin Colon Rectal Surg. 2011;24(3):161-70. doi:10.1055/s-0031-1286000
Georgios SK, Bampali AD.Colorectal cancer. In: Bustamante M, ed.Colonoscopy and Colorectal Cancer Screening - Future Directions. InTech; 2013. doi:10.5772/53524
Issa IA, Noureddine M.Colorectal cancer screening: An updated review of the available options.World J Gastroenterol.2017;23(28):5086–5096. doi:10.3748/wjg.v23.i28.5086
American Cancer Society.Tests to diagnose and stage colorectal cancer.
National Institute of Diabetes and Digestive and Kidney Diseases.Colonoscopy.
National Cancer Institute.Colorectal cancer screening (PDQ)–health professional version.
National Cancer Institute.Colon cancer treatment (PDQ)–health professional version: Table 4. Definitions of TNM stages IIIA, IIIB, and IIIC.
National Cancer Institute.Tumor grade.
Recio-Boiles A, Cagir B.Colon cancer. In: StatPearls.
Batista VL, Iglesias AC, Madureira FA, Bergmann A, Duarte RP, da Fonseca BF.Adequate lymphadenectomy for colorectal cancer: a comparative analysis between open and laparoscopic surgery.Arq Bras Cir Dig. 2015;28(2):105-108. doi:10.1590/S0102-67202015000200005
Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: efficacy results of the Italian Three or Six Colon Adjuvant Trial.J Clin Oncol. 2018;36(15):1478-1485. doi:10.1200/JCO.2017.76.2187
Sobrero A, Lonardi S, Rosati G, et al.FOLFOX or CAPOX in stage II to III colon cancer: Efficacy results of the Italian three or six colon adjuvant trial.JCO. 2018;36(15):1478-85. doi:10.1200/JCO.2017.76.2187
Grothey A, Sobrero AF, Shields AF, et al.Duration of adjuvant chemotherapy for stage III colon cancer.N Engl J Med. 2018;378(13):1177-88. doi:10.1056/NEJMoa1713709
Häfner MF, Debus J.Radiotherapy for colorectal cancer: Current standards and future perspectives.Visc Med. 2016;32(3):172-7. doi:10.1159/000446486
American Cancer Society.Radiation therapy for colorectal cancer.
National Cancer Institute.Cancer stat facts: Colorectal cancer.
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