How is stages of cancer determined

Small cell lung cancer is typically described as either limited stage or extensive disease. Limited stage means the cancer is limited to the chest. Extensive disease means it has extended outside the chest, which requires a different treatment approach.

Will restaging a cancer change the initial stage? When a cancer is staged again after the first staging, it is referred to as restaging. Many times, the same tests that were performed when the cancer was initially diagnosed such as imaging tests, physical exams, and biopsies are done again. The stage assigned at diagnosis remains the most important one to record for statistics like survival rates.

What is a cancer grade, and how is it different from a cancer stage? Cancer cells that look most like normal cells are low-grade tumors. Lower-grade cancers are generally less aggressive and have more favorable prognoses. Cancer cells with high grades tend to be more aggressive. Doctors refer to them as poorly differentiated or undifferentiated. Many types of cancers, but not all, use a standard 1 to 4 grading scale:.

Grade 1 : These tumor cells look most like healthy cells. They are called well-differentiated tumors and considered low-grade. Grade 2 : The cells are somewhat abnormal and are referred to as moderately differentiated.

These are intermediate-grade tumors. Grade 3 : These look very abnormal. They are considered poorly differentiated since they no longer have an architectural structure or pattern. Grade 3 tumors are considered high grade. Treatment can vary based on the type of cancer a person has, as well as other factors, such as their age and overall health. Treatment may involve radiation therapy or surgery to remove the tumor.

The exact outlook for a person with stage 2 cancer will vary based on their age, overall health, and the type of cancer they have. Stage 2 cancer is often treatable and has a high survivability rate. In stage 3 cancer , the tumor is still localized, but it is often larger than stages 1 or 2 and has invaded nearby tissue. It may also affect nearby lymph nodes. Treatment may be more aggressive than for stages 1 or 2.

Treatments will also vary based on the location of the cancer. Stage 3 cancer has a generally lower survivability rate than cancers that doctors diagnose in stages 1 or 2. Stage 4 is the most severe stage of cancer. When a doctor diagnoses stage 4 cancer, the tumor is generally very large, and the cancer has spread to other areas of the body.

A doctor will often recommend a more aggressive treatment plan for people with stage 4 cancer. The aim of treatment is to slow or stop the spread of the cancer and to help a person feel as comfortable as possible. The treatment plan and recommendations will vary based on the type of cancer a person has and what is most effective against it. Options may include radiation therapy, chemotherapy, targeted therapy, and surgery. Stage 4 cancer has a generally less favorable outlook than the other stages of cancer.

Learn more about stage 4 cancer here. The TNM stages make up the most common cancer staging system across the world. The N describes whether or not the cancer has reached nearby lymph nodes. The N can be one of the following:. The M describes whether or not the cancer has spread to other areas of the body.

Possible scores include M0 , in which the cancer has not spread to distant parts of the body, and M1 , in which the cancer has spread to distant parts of the body. In general, the higher the number following each letter, the worse the outlook and more involved the treatment will be.

Cancer grades vary between cancer types. The grading system evaluates both the tumor and the cells within the tumor. The National Cancer Institute indicate that there are generally four grades that a tumor may belong to, ranging from 1—4. The grades describe how close to the normal cells the cancer cells actually are. You will notice that these descriptions refer to the "TNM category.

Clinical staging. Clinical staging is staging that is done before any treatment begins. Your doctor uses information from physical exams, your medical history, and any x-rays, imaging, scans, or diagnostic tests that you had.

They will also use the results of any biopsy that has been done of the cancer, lymph nodes, or other tissue. Clinical staging helps you and your doctor plan the initial steps in your treatment.

Clinical staging is indicated with a small "c" before the TNM category. Pathological staging. Pathological staging is based on the same information as clinical staging, plus any new information gained during surgery if surgery was the first treatment for the cancer.

Pathological staging is indicated with a small "p" before the TNM category. Post-therapy staging. Post-therapy staging is used in cases where surgery is not the first treatment, but other treatments are given before surgery. These treatments can include radiation therapy or drug treatments like chemotherapy, immunotherapy, or hormone therapy.

These treatments may be used before surgery to shrink the tumor to make surgery easier. It can also help doctors learn how well treatments work for the cancer to plan further treatment.

Post-therapy staging is indicated with a "y" before the TNM category. When doctors determine the stage of the cancer using the TNM system see below , every cancer should be staged with clinical staging. After surgery or initial treatments before surgery, pathological staging and post-therapy staging should be used as well.

Clinical staging is very important to help plan initial treatment, but pathological staging or post-therapy staging give the most information. This can help your health care team understand your prognosis. Doctors use the TNM staging system for most types of cancer. The TNM system uses letters and numbers to describe the tumor T , lymph nodes N , whether or not the cancer has spread or metastases M.

Each letter and number tell you something about the cancer. The specific definitions for each category are different for each type of cancer that is staged using this system. Learn more specific staging information for each type of cancer. Tumor T : The letter T and the number after it describe the tumor by answering these questions:. The letter T is followed by a letter, number, or combination of letters after it. This gives additional information about the tumor. The different letters and numbers that may see include:.

TX means that there is no information about the tumor or it cannot be measured. Tis refers to a tumor "in situ.

It has not spread to any surrounding tissue. T1-T4 describe the size and location of the tumor, on a scale of 1 to 4.

A larger tumor or a tumor that has grown deeper into nearby tissue will get a higher number. For some types of cancer, the T stage can be broken down into subcategories for even more detail. This is noted with a lowercase letter, like an "a" or "b", such as "T2b". What these letters mean depends on the type of cancer. A lowercase "m" can also be used to show that there are multiple tumors.

Node N : The letter N and the number after it describe if cancer has affected the lymph nodes. The following explains what the letters and numbers mean:. Regional lymph nodes N. Distant metastasis M. The TNM system helps describe cancer in great detail. But, for many cancers, the TNM combinations are grouped into five less-detailed stages.

When talking about your cancer, your doctor or nurse may describe it as one of these stages:. Another staging system that is used for all types of cancer groups the cancer into one of five main categories.

This staging system is more often used by cancer registries than by doctors. But, you may still hear your doctor or nurse describe your cancer in one of the following ways:. Menu Contact Dictionary Search. Understanding Cancer. What Is Cancer? Cancer Statistics. Cancer Disparities. Cancer Causes and Prevention. Risk Factors. Cancer Prevention Overview. Cancer Screening Overview. Screening Tests. Diagnosis and Staging. Questions to Ask about Your Diagnosis. Types of Cancer Treatment.

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