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Cancer-Stages

Cancer stages

Stage 3 cancer

The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on August 19, 2021.

Stage 3 cancer is a serious disease that requires expert care. At Cancer Treatment Centers of America® (CTCA), we use a variety of sophisticated tests and procedures to confirm the stage of your disease and develop a comprehensive treatment plan designed just for you.

Patients whose cancer has advanced to stage 3 may consider a second opinion to confirm their diagnosis and explore new treatment options. Chat with us to set up an appointment with one of our cancer experts.

What is Stage 3 cancer?

Stage 3 cancer is sometimes referred to as locally advanced cancer. In this stage, the tumor may have grown to a specific size, the cancer may consist of multiple tumors, and/or the cancer may have spread to adjacent lymph nodes, organs or tissue. In some cases, stage 3 cancers may be considered metastatic cancers, meaning they may have spread beyond their organ of origin.

Many stage 3 cancers have multiple subcategories, usually designated as stages 3A, 3B and 3C. These subcategories are often determined by the size of the tumors, whether multiple tumors are present and the degree to which the cancer has spread locally.

Liquid cancers, or blood cancers, such as leukemia, lymphoma or multiple myeloma, are staged differently than most other cancers because they may not always form solid tumors. Liquid cancers may be staged by a variety of factors, including:

  • The ratio of healthy blood cells to cancerous cells
  • Whether cancer cells are found in lymph nodes or the diaphragm
  • The degree to which lymph nodes, the liver or spleen may be swollen

Stage 3 cancer is determined in the five most common cancers this way:

Stage 3 breast cancer

The tumor may also be quite large at this stage, possibly extending to the chest wall and/or the skin of the breast. Cancer cells may be found in nearby lymph nodes.

Learn more about breast cancer stages

Stage 3 lung cancer

The cancer has spread from the lungs to the lymph nodes and/or to nearby structures and organs, such as the heart, trachea and esophagus.

Learn more about lung cancer stages

Stage 3 prostate cancer

The cancer is in tissues near the prostate. It also may have reached the seminal vesicles, the glands that secrete components of semen.

Learn more about prostate cancer stages

Stage 3 colorectal cancer

The cancer has grown into the intestine wall and may have entered the muscle. The cancer may have spread to nearby lymph nodes and/or into nearby organs or tissues.

Learn more about colorectal cancer stages

Stage 3 melanoma

The cancer cells have spread to nearby lymph nodes, but not to distant organs.

Learn more about melanoma stages

Staging and grading for stage 3 cancer

Staging is an important factor in determining cancer treatment options, since it establishes the tumor’s size and spread within the body. Staging is used for most cancers, but not all. Cancers in and near the brain, for example, don’t use a defined staging system because their likelihood of spreading is low.

In general, cancer falls within stages 1 through 4. Some types may be stage 0, meaning there are cancerous cells in a layer of tissue, but they haven’t grown or spread.

Most cancers are staged using some form of the TNM system. Doctors may also use the TNM system to help determine the extent of certain cancers in each stage. The TNM system stands for:

  • T (tumor), for the size of the original tumor
  • N (node), whether the cancer is present in the lymph nodes
  • M (metastasis), whether the cancer has spread to other parts of the body

Some cancers, especially liquid cancers, are staged using different established protocols. The Binet and Rai systems, for example, are used to stage certain types of leukemia. Cancers of the female reproductive system, such as cervical cancer and ovarian cancer, are staged using the FIGO staging system, designed by the International Federation of Gynecology and Obstetrics (FIGO).

Regardless of the system used, the first step for doctors staging cancer is to gather information about it. Some tests or procedures that may be involved as your care team is staging your cancer include:

Grading is sometimes also a part of the staging process, depending on the type of cancer. Staging tells you the extent of the cancer. Grading, on the other hand, looks at the cancer cells specifically and uses them as clues to predict the cancer’s pace of growth. Low-grade tumors tend to grow slowly, and high-grade tumors tend to grow more rapidly. Grading especially informs treatment options in breast cancer, prostate cancer and brain tumors.

After a tumor biopsy or surgery, a sample of the cancerous tissue is sent to a lab. If cancer cells are found, a pathologist compares them to normal tissue cells. If they look similar, the cancer is low-grade. If they structurally appear very different, the tumor is high-grade. Sometimes, the pathologist won’t be able to determine the grade. Other times, the grade may be right in the middle (intermediate)—neither low nor high. The grade of your cancer is part of how your care team stages your cancer and determines your prognosis.

When it comes to grading, tumors generally may be referenced in the following ways.

  • GX is an undetermined grade: A pathologist couldn’t tell the grade of the cancer cells.
  • G1 is a low grade: Also called well differentiated, these tumors tend to spread slowly and have cells and tissue that look very similar to normal cells and tissues.
  • G2 is an intermediate grade: Also called moderately differentiated, these tumors have cells and tissue that somewhat resemble normal cells and tissues, but there are noticeable differences.
  • G3-G4 are both high grade: Also called poorly differentiated (G3) and undifferentiated (G4), these tumor cells look markedly different from normal ones and are likely to grow and spread quickly.

Cancers of the central nervous system (CNS) are graded rather than staged. Grade 3 brain and spinal cancers are considered fast-growing and may have invaded nearby tissues.

Treatment options for stage 3 cancer

In general, regimens for stage 3 cancers typically start with either surgery or treatment to shrink the tumor before surgery, such as chemotherapy, radiation, or a combination of both.

Stage 3 breast cancer treatment: The first step is typically either chemotherapy or surgery.

Called neoadjuvant chemotherapy, because it’s given before other treatment, this may help shrink a tumor enough that breast-conserving surgery (BCS) is possible. If it doesn’t shrink enough, the patient may need a mastectomy (removal of full breast) instead. HER2-positive cancers may also be treated with targeted drugs before surgery.

After surgery, depending on the type of breast cancer, your treatment may continue with radiation. Chemotherapy and/or targeted drugs may be part of your treatment plan after surgery as well.

Stage 3 lung cancer treatment: This is highly dependent on how large the tumor is and which lymph nodes are affected. Generally, treatment begins with chemotherapy and/or radiation. You may have chemotherapy and radiation at the same time, or you may have them one after another. Surgery may follow this treatment if your care team thinks the remaining cancer may be successfully removed. After surgery, additional chemotherapy and/or radiation may be part of your treatment plan.

If chemotherapy, radiation or surgery aren’t appropriate options, immunotherapy drugs may be.

Stage 3 prostate cancer treatment: The approach for stage 3 prostate cancer tends to be radiation therapy and hormone therapy. In some cases, surgery may be an option, with radiation and/or hormone therapy afterward. Clinical trials may also be an option.

People who are older or have complex health problems may opt to only have hormone therapy or radiation therapy as a less aggressive treatment option. Even with stage 3 prostate cancer, holding off on treatment and sticking with regular observation may be an option sometimes.

Stage 3 colorectal cancer treatment: Stage 3 colon cancer is most commonly treated with surgery to remove the cancer and repair the colon, followed by chemotherapy. Ask your care team about any appropriate clinical trials.

Treatment for stage 3 rectal cancer is most often the opposite: It begins with chemotherapy and radiation at the same time (chemoradiation) to shrink the cancer and prepare for a successful surgery. Once the cancer is removed through surgery, about six months of chemotherapy typically follows.

Stage 3 melanoma treatment: First-line treatment for stage 3 melanoma tends to be surgery. Since stage 3 melanoma involves cancer spreading into the lymph nodes, surgery removes the primary tumor itself, any “in-transit” tumors under the skin and the affected lymph nodes. Afterward, radiation, targeted therapy or immunotherapy may be options that your care team recommend to lower the chance of recurrence.

For melanoma that cannot be removed with surgery, treatment options include immunotherapy, targeted therapy and chemotherapy. Clinical trials may also be an option.

How to find support

You may be overwhelmed with organizations offering support, or you may be confused as to how to enroll or whether you’re eligible. Though some of these support options happen outside of your care team’s facility, speak openly with them about what kind of support you need and any questions to start.

Stay connected with your care team: They know you and they know the battle ahead. They also know which resources have been helpful for other patients, and which resources they may be able to offer. They know that factors such as stress, nutrition and sleeping problems affect your health. They’re there to help you get what you need.

Lean on friends and family: Interactions with friends and family may be different when a cancer diagnosis is involved. Odds are that your support system wants to help, but they’ll know the best ways to help if you tell them yourself. Don’t be afraid to ask for what you need, whether it’s company on the ride to an appointment or help with household chores.

Look for support groups: If you have stage 3 cancer, you’re joining a host of others who have walked a similar path. You’re not alone. Participating in a support group may help you feel more connected and understood. Both the American Cancer Society and the National Cancer Institute have tools to help you find resources for cancer support in your area.

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