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Colorectal cancer

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Treatments for stage III colon cancer

The following are treatment options for stage III colon cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery

Surgery is the primary treatment for stage III colon cancer. A bowel resection is the type of surgery done. Depending on the location of the tumour, the surgeon may do a right hemicolectomy, transverse colectomy, left hemicolectomy, sigmoid colectomy, subtotal colectomy or total colectomy.

The surgeon also removes at least 12 nearby lymph nodes (called lymph node dissection).

A colostomy may be done to allow the intestines to rest and heal after the bowel resection. The colostomy is usually temporary. The 2 ends of the colon are joined together after they have healed.

Chemotherapy

Chemotherapy is usually given after surgery for stage III colon cancer to reduce the risk of recurrence. Chemotherapy can be started 4–8 weeks after surgery and is usually given for 6 months.

The types of chemotherapy used include:

  • FOLFOX – leucovorin (folinic acid), 5-fluorouracil (Adrucil, 5-FU) and oxaliplatin (Eloxatin)
  • CAPOX (also called XELOX) – capecitabine (Xeloda) and oxaliplatin (Eloxatin)
  • capecitabine (Xeloda)
  • 5-fluorouracil (Adrucil, 5-FU) with leucovorin (folinic acid)

FOLFOX or CAPOX is the preferred chemotherapy treatment for stage III colon cancer. Sometimes oxaliplatin can’t be used because the person already has nerve damage, and this drug can make that nerve damage worse. When oxaliplatin can’t be used, capecitabine or 5-fluorouracil can be given alone.

Capecitabine is given as a pill by mouth (orally). 5-fluorouracil is given through a needle in a vein (intravenously). Capecitabine is used more often than 5-fluorouracil with leucovorin because it is easier to take and tends to have fewer side effects. Both drugs are equally effective in treating stage III colon cancer.

Radiation therapy

Radiation therapy may be offered after surgery to help prevent cancer from coming back in the same area (called a local recurrence). It may be offered if:

  • the tumour has grown into or is attached to nearby tissues or structures
  • all of the cancer couldn’t be removed with bowel resection

Radiation therapy isn’t a common treatment for stage III colon cancer because colon cancer doesn’t usually spread locally. If it spreads, it is more likely to spread to distant organs such as the liver.

Clinical trials

You may be asked if you want to join a clinical trial for colon cancer. Find out more about clinical trials.

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