Rectal cancer

Hi. Had surgery last week to remove lymph nodes following removal of rectal lesion which had focus of cancer inside.  Results this morning over the phone. Out of 10 nodes 1 involved so chemo recommended. Surgeons said t1. Stage 3. No spread to other organs. Hasnt come out of muscle wall.   I think t1 means an early cancer is that right.  The stage 3 worried me and not so sure what this means.  

Last weeks surgery was complicated due to endometriosis and had full hysterectomy and stoma fitted.   I’m worrried how I will cope with chemo whilst still recovering.  

waiting on oncologist now to contact me.  

  • Dear Bowelbehavingbadly,

    Thank you for getting in touch. My name is Kat, I am one of the Cancer Information Nurses on the support line. I hope you are recovering well from your surgery.

    It can be overwhelming to hear your results over the phone.

    There are different ways to stage bowel cancer and the most common are TNM staging and number stages.

    You mentioned your consultant has said that your cancer is T1. When the consultant is referring to T it is a simplified version of TNM Stage. T1 means that cancer is only on the inner lining of the bowel.

    As your cancer has not spread through the bowel lining but has spread to a lymph node this makes the number stage of the cancer stage 3.

    For a stage 3 cancer surgery and chemotherapy can be given as this should reduce the chances of the cancer returning in the future.

    The thought of chemotherapy can be overwhelming when you are still recovering from surgery. Your treatment team will give you some time to recover. It is important that you let your treatment team know your concerns.

    Your treatment team will be able to give you some medication to help with the side effects of the chemotherapy.

    If you feel that during your chemotherapy you are struggling to cope. Let your treatment team know so they can help arrange some support for you.

    It can sometimes be helpful to speak to some one about how you are feeling. You can call us on 0808 808 00 00 and speak to one of our nurses.

    Best wishes and take care,


    Cancer Information Nurse Specialist. 

    Best wshes and take Care,
    Cancer Information Nurse Specialist
  • Thank you for your advice.  I just couldn’t understand how it has gone to a lymph node if it has protruded the bowel and wondered if this was due to removal of tumour in earlier transanal operation.  How worrying is lymph node involvement in terms of prognosis

  • Hi Bowelbehavingbadly,  

    My name is Deborah and I’m one of the Cancer Information Nurses. I understand your concern over how the cancer cells may have spread from your rectum into a nearby lymph node. Hopefully, I can explain a bit more about this.

    As Kat said above, there are different ways to categorise rectal tumours. Your surgeon has used two different systems to describe your cancer, both of which tell us different things about it.

    The “T” part of the TMN system tells us the size of the tumour. T1 rectal cancer means the tumour is only in the inner layer of the bowel.

    Your surgeon also used the number system and described your cancer as a stage 3. There are 3 groups within stage 3 cancer – 3A, 3B and 3C. From the information you’ve given, it sounds like you have a stage 3A rectal cancer. This means that the cancer is still in the inner or muscle layer of the bowel wall, and it has spread to between 1 to 3 nearby lymph nodes or to areas of tissue close to the lymph nodes.


    Sometimes cancer cells break off from where they started, for example, in your rectum, and they travel through your bloodstream or your lymphatic system and can end up in your lymph nodes. This can happen at any time and is very difficult to predict.

    In response to your question about whether your previous surgery may have caused the cancer cells to spread to your lymph nodes, I’m afraid that’s a very difficult question to answer. The likelihood of surgery causing cancer cells to spread is extremely low, although it is not impossible. Unfortunately, there’s no real way of knowing whether this might have increased your risk of the cancer spreading.


    In terms of prognosis, there are no UK-wide statistics available for bowel cancer survival by stage. However, Cancer Research UK have some information on survival statistics which you might find helpful. Their research shows that almost 70 out of every hundred people (almost 70%) with stage 3 bowel cancer (also called Dukes' C) will survive their cancer for at least 5 years or more after they're diagnosed. I should point out that the reason statisticians talk about 5 year survival rates isn't that they think people are less likely to survive this length of time, they're just recorded 5 yearly. Also, these statistics do not reflect any other health conditions, lifestyles or risk factors of people with this diagnosis, so you should always take these figures with a pinch of salt. These are general statistics and might not reflect your own personal circumstances.


    I hope this has been helpful. If you would like to speak to one of our nurses, you are welcome to call the support line on 0808 808 0000. We’re open every day, 8am-8pm.


    Best wishes


    Deborah, Macmillan Information Nurse Specialist