Cervix Carcinoma Stage III
Stage 3 cervical cancer means the disease has spread beyond the cervix into surrounding structures in the pelvis or into nearby lymph nodes, but has not yet reached distant parts of the body. Understanding the extent of cancer spread helps doctors choose the most effective treatment approach.
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What is Stage 3 Cervical Cancer?
The stage of a cancer tells you how big it is and whether it has spread. This information helps your doctor decide which treatment you need[1]. Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer, which includes four stages numbered 1 to 4[1].
Stage 3 cervical cancer means the cancer has spread from where it started in the cervix into the surrounding tissue[1]. At this stage, the cancer may have grown into the lower part of the vagina, the pelvic wall (the muscles or ligaments lining the area between the hip bones), or it may be affecting the tubes that drain the kidneys[1]. The cancer may also have spread to lymph nodes in the pelvis or abdomen[1].
In stage 3, cervical cancer has spread to areas of your pelvis beyond your cervix, which can include the lower part of your vagina, the pelvic walls, and nearby lymph nodes[4]. At this point, the cancer has not yet spread to more distant parts of the body[4].
Substages of Stage 3
Stage 3 cervical cancer can be divided into substages: 3A, 3B, and 3C. If scans show cancer has spread to the lymph nodes, stage 3C is further divided into 3C1 and 3C2[1].
Stage 3A is when the cancer has spread to the lower third of the vagina but not to the pelvic wall[1].
Stage 3B means one or both of the following: the tumor has grown through to the pelvic wall, or it is blocking one or both of the tubes that drain the kidneys (the ureters)[1].
Stage 3C means the cancer can be any size in the pelvis but has not spread to distant sites in the body. However, scans show that cancer has spread to lymph nodes[1]. Stage 3C1 means cancer is in the nearby pelvic lymph nodes, while stage 3C2 means cancer is in the para-aortic lymph nodes (lymph nodes in the abdomen)[1].
Treatment Options
The stage of your cancer helps your doctor decide which treatment you need. Treatment also depends on your type of cancer (the type of cells the cancer started in), where the cancer is, and other health conditions that you have[1].
Treatment for stage 3 cervical cancer is a combination of chemotherapy and radiotherapy (chemoradiotherapy). You might have chemotherapy before these treatments (neoadjuvant chemotherapy)[1]. Most people with stage 3 cervical cancer will receive a combination of external and internal radiation therapy[10].
With chemoradiotherapy, you have chemotherapy during your course of radiotherapy. You have chemotherapy once a week. You have daily external radiotherapy for 5 days every week, for around 5 weeks. You also have internal radiotherapy (brachytherapy)[1]. Before you have these treatments, you might have chemotherapy, called neoadjuvant chemotherapy[1].
Chemotherapy drugs, such as cisplatin or carboplatin, may be given at the same time as radiation therapy. Giving chemotherapy at the same time as radiation therapy helps the radiation therapy work better[10]. If cisplatin is used, it is usually given one time each week during the radiation therapy schedule. If cisplatin plus 5-fluorouracil is used, it is usually given every 4 weeks during radiation therapy[11].
You might also have a boost of radiotherapy if there is a risk of any cancer cells in pelvic lymph nodes[1]. Very rarely, you might have surgery to remove the lymph nodes around your cervix and womb (pelvic lymph nodes). This is because there is a risk the cancer may have spread from the cervix to the nearby lymph nodes[1].
Treatment may also include immunotherapy[10]. Surgery to remove pelvic lymph nodes followed by radiation therapy with or without chemotherapy may be an option in some cases[10].