December 31, 2021
One of the quintessential questions any patient would ask after getting that dreaded cancer diagnosis is – what stage is the cancer in? Many of us are aware that the severity of this particular condition is determined by its stage, defined numerically – 1, 2, 3 and 4. Though it is of general understanding that number 1 indicates that starting stage, with 4 ranking severities at the highest, there is a lot more to that.
In this article, we will take you through all you should know about different stages of cancer, how it is done, why it is important in understanding the stages before zeroing in on the treatment plan.
Cancer is not just one word; it is an amalgamation of type, origin, cell growth, a wide range of symptoms, and it is crucial to understand the specific type. A cancer diagnosis is a detailed process that includes lengthy blood work, diagnostic imaging including MRI, PET-CT, biopsy, biomarkers, where all results are thoroughly assessed before charting out the route for proper treatment.
From a layman’s point of view, the medical terminology may be intriguing but do not hesitate or be afraid to ask questions – staying informed makes you feel assured! Remember, having a positive attitude helps you in a great way in combating cancer for that desired outcome.
And here’s what you should know about the stages of cancer.
1. Why Is Cancer Staging Important?Staging the cancer is the foremost step in deciding the course of treatment, including surgery, if or when chemotherapy and radiation need to be administered. It helps the medical experts in understanding the condition and evaluating the prognosis if the treatment worked and also predicting recurrences.
2. How Is Cancer Staging Done?
Clinical staging is done at the time of diagnosis, even before the treatment begins. The surgeon correlates the results of various diagnostic tests, including physical examination, imaging results, biopsy etc., before planning the best possible treatment for the patient.
Pathological staging is done during the surgery, especially if the doctor recommends it as the first line of treatment for a particular cancer type.
Post Therapy Staging:
This particular evaluation is done to understand how treatment options like chemotherapy, radiation, immunotherapy, hormone therapy and drugs have worked in eliminating or shrinking the cancer cells. It helps the expert in planning the next course of treatment.
3. What Is TNM In Cancer Staging?
TNM is the common way of deciding the stages of tumours.
- Tumour (T): The alphabet T indicates Tumour, and it also defines the number to specific questions such as the size of the tumour, location and if it spread to other parts of the body.
- TX: It means that there is no information about the growth of cancer cells or tumours and couldn’t be measured.
- T0: There is no evidence to prove the presence of a tumour.
- Tis: It means tumour ‘’in situ’’ meaning the tumour is located in the cells where it originated from, and it has not spread to surrounding tissues.
- T1-T4: These numbers define the size, location of the tumour on a scale of 1 to 4.
- Node (N): Node is used to describe if the cancer has spread to lymph nodes, which are tiny, bean-shaped organs that play a major role in fighting infections. This is analysed through lymph node dissection, where the lymph nodes are collected and examined under the microscope for the presence of cancer cells. Both regional and distant lymph nodes may be examined for abnormalities.
- Metastasis (M): The letter M explains Metastasis, which implies the cancer spreading from its site of origin to other parts of the body. If cancer has not spread, it is M0, and if it has reached to other parts of the body, then it is M1.
4. Other Staging Methods:
The grade is a method to describe how much cancer cells look like healthy cells. A pathologist decides on the grade of cancer cells by examining and evaluating cells, tissues and biopsy samples from the organ to compare cancer cells with healthy ones. If cancer looks like a healthy tissue with different cell groupings, it is determined as a low-grade tumour. If cancer projects a different impression from healthy cells, it is a high-grade tumour. The grade defines how quickly cancer can metastasise from 1 to 3 or 1 to 4 in some.
Biomarkers or tumour markers are substances found in higher levels in blood, urine or even in tissues if there is tumour growth in the body. These biomarkers aid in disease staging, treatment planning and understanding how certain types of cancer spread.
The study of tumour genetics helps in predicting cancer metastasis and also in devising suitable treatment plans for the patient based on the type of cancer.
5. What Is Cancer Stage Grouping?
The oncologists decide upon the stage grouping of cancer, based on the TNM from 1 to 4, but certain cases also have stage 0.
- Stage 0: It is often described as in situ, which means it is confined to the placewhere it started and has not spread to other tissues. Treating stage 0 cancers is relatively easier, and it is associated with higher survival rates.
- Stage 1: This stage defines the presence of cancer but has not grown deeply into nearby tissues, lymph nodes or other parts of the body. This is an early-stage tumour.
- Stage II and Stage III: In this stage, the cancer cells have penetrated deeply into nearby tissues, may have reached lymph nodes but not to other parts of the body.
- Stage IV: It means that the cancer cells have spread to other parts of the body. It is an advanced or metastatic stage of cancer.
Staging serves multiple purposes – it helps the doctor understand the extent of the disease, come up with a treatment plan that works, and most importantly, it helps the patients know what to expect.
That said, it is crucial for patients to not jump to any conclusions after learning the stage of their condition. Each patient is different, so is each case. Therefore, patients are advised to have a detailed discussion with their doctor in order to understand what the received diagnosis means and what are the best ways to deal with it.