What is Staging:
Staging is the extent or severity of an individual’s cancer. Stage 0 is sometimes referred to as pre-cancer and stage IV is advanced cancer that has spread beyond its original organ site.
After cancer has been diagnosed, doctors ask and answer the following three questions to determine how far your disease has progressed:
- How large is your tumor, and how deeply has it invaded (spread into) surrounding tissues?
- Have cancer cells spread to regional lymph nodes?
- Has the cancer spread (metastasized) to other regions of your body?
Based on the answers to these questions, the cancer is assigned a "stage." A patient's chances for survival are better when cancer is detected at a lower stage.
How cancer staging is determined:
Exams and tests are done to learn the extent of the cancer within the body. In this process, doctors evaluate whether or not the cancer has spread from the original site to other parts of your body.
Staging systems for cancer have evolved over time and continue to change as scientists learn more about cancer.
What types of tests are used to determine stage?
- Physical exams
- Imaging studies
- Laboratory tests
- Pathology report (microscopic examination of your cancer)
- Surgical reports
Help understanding tumor size:
Doctors refer to tumor size in centimeters rather than inches.
*rulers not to scale
2 ½ centimeters = ~ 1 inch.
A penny = ~ 2 centimeters = ~ 3/4 th of an inch
So if your doctor tells you that you have a 2 centimeter tumor, go find a penny and look at it. This will be very close to the size of your tumor.
It is important to know what stage you are as most treatment decisions are based on your tumor stage. Write down your stage in your diagnosis binder for future reference.
Carcinoma in situ (early cancer that is present only in the layer of cells in which it began; may be referred to as pre-cancer by some doctors).
- Stage I, Stage II, and Stage III
Higher numbers indicate more extensive disease: greater tumor size, and/or spread of the cancer to nearby lymph nodes and/or organs adjacent to the primary tumor.
The cancer has spread to another organ.
What else should you know about staging?
Doctors might estimate prognosis or survival time, based on the cancer stage.
However, survival is different in every individual and estimates are averages calculated from a large group of people. Nobody can predict survival. Remember, fifty percent of people live longer than the average.
Always remember that statistics are about large groups, not about you.
Always talk to your doctor about information read here or on other web-sites.
Systems of Staging
Often competing staging systems exist for the same type of cancer; however, the universally-accepted staging system is that of the UICC, which has the same definitions of individual categories as the AJCC.
Systems of staging may differ between diseases or specific manifestations of a disease.
What is the TNM system?
The TNM staging system is based on the extent of the tumor (T), spread to lymph nodes (N), and metastasis (spread to other parts of the body) (M).
The TNM system is one of the most commonly used staging systems. Most medical facilities use the TNM system as their main method for cancer reporting. PDQ®, the National Cancer Institute's (NCI) comprehensive cancer database, also uses the TNM system.
The TNM system is based on the extent of the tumor (T), the extent of spread to the lymph nodes (N), and the presence of metastasis (M). A number is added to each letter to indicate the size or extent of the tumor and the extent of spread.
Primary Tumor = (T)
TX = Primary tumor cannot be evaluated
T0 = No evidence of primary tumor
Tis = Carcinoma in situ (early cancer that has not spread to neighboring tissue)
T1, T2, T3, T4 = Size and/or extent of the primary tumor
Regional Lymph Nodes = (N)
NX = Regional lymph nodes cannot be evaluated
N0 = No regional lymph node involvement (no cancer found in the lymph nodes)
N1, N2, N3 = Involvement of regional lymph nodes (number and/or extent of spread)
Distant Metastasis = (M)
MX = Distant metastasis cannot be evaluated
M0 = No distant metastasis (cancer has not spread to other parts of the body)
M1 = Distant metastasis (cancer has spread to distant parts of the body)