Stage 3 cervical cancer

Stage 3 means the cancer has spread from the cervix into the structures around it or into the lymph nodes in the pelvis or abdomen. You might have chemotherapy before chemoradiotherapy (neoadjuvant chemotherapy). 

What is stage 3 cervical cancer?

The stage of a cancer tells you how big it is and whether it has spread. It helps your doctor decide which treatment you need.

Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer. There are 4 stages, numbered 1 to 4. 

Stage 3 means one or more of the following. The cancer has spread away from the cervix and into:

• the lower third of the vagina
• the pelvic wall - the muscles or ligaments lining the area between the hip bones (pelvis)
• one or more of the tubes draining the kidneys (the ureter), causing kidney problems
• lymph nodes in the space between the hip bones (pelvic lymph nodes)
• lymph nodes in the tummy (abdomen) called para-aortic lymph nodes

Stage 3 can be divided into:

• stage 3A
• stage 3B
• stage 3C - which is then further divided into stage 3C1 and 3C2 if scans show cancer has spread to the lymph nodes

Stage 3A

Stage 3A is when the cancer has spread to the lower third of the vagina but not the pelvic wall.

Stage 3B

Stage 3B means one or both of the following. The tumour:

• has grown through to the pelvic wall
• is blocking 1 or both of the tubes that drain the kidneys (the ureters)

Stage 3C

Stage 3C means the cancer can be any size in the pelvis but has not spread to distant sites in the body. 

If scans show cancer has spread to lymph nodes, 3C is then divided into:

• 3C1
• 3C2

Stage 3C1 means cancer is in the nearby pelvic lymph nodes. 

Stage 3C2 means cancer is in the para-aortic lymph nodes (in the abdomen). 

Treatment

The stage of your cancer helps your doctor to 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
• other health conditions that you have

Stage 3 cervical cancer might be treated with: 

• chemotherapy before chemoradiotherapy (neoadjuvant chemotherapy)
• combined chemotherapy and radiotherapy (chemoradiotherapy) and brachytherapy
• a boost of radiation to any pelvic lymph nodes seen on a scan
• surgery to remove lymph nodes

Combined radiotherapy and chemotherapy (chemoradiotherapy)

With this treatment, 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).

Before you have the above treatments, you might have chemotherapy. This is called neoadjuvant chemotherapy. 

You might also have a boost of radiotherapy if there is a risk of any cancer cells in pelvic lymph nodes.

Surgery

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.

Other stages