If you or a loved one receives a cancer diagnosis, you probably have a lot of questions. Many patients ask questions like: How advanced is my cancer? What kind of treatments are available? What is my prognosis? You may feel uncertainty and fear during this time. Understanding the cancer staging system and how it affects treatment planning can help you prepare for what is ahead.
What Is Cancer Staging?
When you are diagnosed with cancer, your doctor will conduct tests to determine the tumor's location, size, and severity. This process is known as cancer staging. Cancer staging also helps doctors predict how the cancer will change or spread.
Knowing the cancer's stage is important for determining the best treatment options. Your oncologist may be able to treat an early-stage cancer with surgery or medication. Advanced stages may require chemotherapy, radiation, immunotherapy, or a combination of treatments.
Often, patients will see multiple doctors and healthcare professionals during the course of their cancer treatments. The cancer stage gives healthcare professionals a quick way to describe the tumor's severity.
Although cancer staging is an important factor in determining a treatment plan, it is not the only factor. Your oncologist will consider your age, medical history, current health, and personal preferences when developing a treatment plan. The tumor's location, genetic makeup, and grade will also impact the treatment plan.
Tests to Determine the Cancer Stage
Your doctor will conduct tests to determine the cancer's stage. A physical exam is important for staging many types of cancers, including skin, breast, bladder, prostate, and testicular cancers. During this exam, your doctor will determine the size and location of the tumor. Your doctor also will check your lymph nodes for signs that the cancer has spread.
Imaging tests have many different applications in the oncology field. Doctors can use these tests to screen for certain types of cancers. For example, a mammogram is an imaging test used to detect changes in breast tissue that can indicate breast cancer. If your doctor suspects you have cancer, they may order imaging tests, such as CT scans, MRIs, PET scans, x-rays, and ultrasounds. These tests give your medical team a better view of the tumor. Your doctor will determine if the cancer has spread to other parts of the body.
The diagnosis process often includes a biopsy to confirm the presence of cancer. During the biopsy, your doctor will remove tissue from the suspected tumor using a needle, endoscope, or scalpel. Many patients feel apprehensive about undergoing a biopsy. An anesthesiologist will administer a local or general anesthetic before the test to ensure you are as comfortable as possible. After the biopsy, a pathologist will examine the tissue for abnormalities.
How Doctors Determine the Cancer Stage
Once your doctor has all the test results, they will determine the cancer's stage. For many cancers, doctors will use the TNM system. This system considers the tumor's size and location. It also considers if the tumor has spread to nearby lymph nodes or spread to other areas of the body.
Your medical team will determine the cancer's stage when you are diagnosed. For most cancers, they will assign a number between 0 and 5. They may update the stage right before treatment or surgery. Knowing the cancer's stage can help your oncologist identify the best treatment protocols and prepare for possible outcomes.
Stage 0 Cancer
When a patient has Stage 0 cancer, they have either pre-cancerous cells or abnormal cells. These cells have not spread to nearby tissue. Some examples of Stage 0 cancer include adenocarcinoma of the cervix, ductal carcinoma of the breast, and squamous cell carcinoma. Stage 0 cancers are often curable.
Stage 1 Cancer
Stage 1 cancer refers to a small tumor located in one area of the body. In this stage, the cancer has not spread to the lymph nodes or other areas of the body. Some people also call Stage 1 early-stage cancer or localized cancer.
Depending on the cancer's type and location, your oncologist may recommend surgery to remove the tumor. Your doctor also may recommend other treatments like chemotherapy or radiation. In some types of cancer, your medical team may decide to monitor the tumor for a while before treating it.
Stage 2 Cancer
In Stage 2, the tumor grows larger. For example, a stage 1 tumor on the kidney is smaller than three inches. When the tumor exceeds three inches, it enters Stage 2. In some cases, the tumor may spread to nearby lymph nodes.
Surgery is a common treatment for Stage 2 cancers. During surgery, the oncologist will remove the tumor. After surgery, your medical team may recommend additional chemotherapy or radiation to eliminate any remaining cancerous cells.
Stage 3 Cancer
Some medical professionals refer to Stage 3 as locally advanced cancer.
When cancer reaches Stage 3, it becomes deeply embedded in the surrounding tissues. It also may spread beyond the initial tumor to nearby lymph nodes. An oncologist may also label the cancer as Stage 3 if there are multiple tumors in the same area or if the tumor reaches a certain size.
Doctors may add an A, B, or C to the stage. In Stage 3A, the cancer has spread to lymph nodes and surrounding tissues. If the cancer advances beyond the lymph nodes to nearby glands or organs, then it is considered Stage 3B. In Stage 3C, the cancerous cells spread through many tissues and lymph nodes, but the cancer remains in one region of the body.
Stage 3 cancer treatments vary depending on the cancer type. Like earlier stages, these cancers often require a combination of surgery, chemotherapy, or radiation.
Stage 4 Cancer
Stage 4 cancer, or metastatic cancer, is an advanced cancer. When cancer metastasizes, it spreads to distant areas of the body. For example, when breast cancer enters Stage 4, it spreads beyond the breasts, armpits, and surrounding lymph nodes. Metastatic breast cancer may spread to the bones, brain, or liver.
Stage 4 cancer is a serious medical condition. Your medical team may recommend chemotherapy, radiation, or immunotherapy. Immunotherapy involves using medications to stimulate the body's immune system to attack the cancer cells. Like chemotherapy, immunotherapy may have side effects, such as fatigue, nausea, and vomiting.
Does Stage 5 Cancer Exist?
For most cancers, Stage 4 is the most advanced stage. For nephroblastoma, a type of kidney cancer that occurs in childhood, there is a fifth stage. Stage 5 nephroblastoma means that the cancer has spread to both kidneys.
Finding Hope After Diagnosis
Anxiety, fear, and uncertainty are common reactions to a cancer diagnosis. Understanding the importance of cancer staging can help you prepare yourself and your family for what is ahead.
Disclaimer: This article is for informational purposes only and is not intended to be a substitute for professional consultation or advice related to your health or finances. No reference to an identifiable individual or company is intended as an endorsement thereof. Some or all of this article may have been generated using artificial intelligence, and it may contain certain inaccuracies or unreliable information. Readers should not rely on this article for information and should consult with professionals for personal advice.