A cancer diagnosis usually starts a discussion about stage, grade, genome testing, and the treatments available to treat that specific type of cancer based on these factors. To make better sense of it all, it’s helpful to become familiar with cancer terminology, especially staging. Not only will this give you an idea of where you are starting in your cancer journey, but it will also make it easier to know what questions to ask your oncologist and cancer care team.
How a Tumor Becomes a Tumor
Healthy cells have a typical rate of production to replace cells that have died. Sometimes, however, cells don’t follow this pattern. This results in uncontrolled growth and/or old cells remaining in place rather than dying off to make room for new ones. These extra cells can cluster together to form a mass, also known as a tumor.
Tumors can be benign (non-cancerous) or malignant (cancerous). Benign tumors tend to grow slowly and stay contained to the area where it originated. Unfortunately, malignant tumors grow faster than benign tumors, and will spread. This means the abnormal cells can start to grow in the lymph system, affecting lymph nodes, and even develop in other areas of the body. It’s important to note that when the cancer spreads to other areas of the body it’s still treated like the cancer that started in the original location. For example, if breast cancer spreads to the bones, the treatments are specific to breast cancer in the bones, not bone cancer.
The Importance of Cancer Staging
Through the staging process, your oncologist can determine where your cancer started and how far it has progressed. This information provides insight into what the most effective course of treatment will be for you. It may also help them decide if or when surgery would be most appropriate.
Staging also helps your oncologist better understand your prognosis, and it will determine if you’d qualify for participating in a clinical trial.
When and How are Cancer Stages Determined?
After reviewing your diagnosis and the images taken of the cancer, your oncologist will be able to get close to determining your stage. They’ll know the approximate size and whether it’s spread to other areas of the body. If the cancer seems to be localized, there will need to be a biopsy of the lymph nodes that are closest to the starting point to see if the cancer has spread there. This is often done at the same time surgery takes place. The results of the lymph node biopsy will have an impact on whether you will need systemic medical oncology treatments such as chemotherapy.
There are four different types of staging that might be used:
- Clinical staging determines how much cancer there is based on physical examination, as well as other tests, including imaging tests, endoscopy exams, and biopsies.
- Pathological staging can be determined after surgery has been done to remove the tumor. The results gained from surgery are combined with the results of clinical staging, providing even more precise information regarding the tumor.
- Post-therapy or post-neoadjuvant therapy staging is used in cases where other treatments, such as chemotherapy, radiation therapy, or immunotherapy, are given prior to surgery or where no surgery is performed. This type of staging gives doctors insight into how well these non-surgical approaches work.
- Recurrence staging is sometimes used to determine the extent of the disease if a cancer comes back after treatment. This information helps guide decisions about further treatment.
Your Stage Doesn’t Change After Diagnosis
The cancer will still be referred to by the stage that was received from the beginning, even if it grows or spreads. Any new information gathered about changes in the cancer will be added to the original stage. In other words, even if the cancer might change, the stage itself will not.
Cancer Staging: How the Stages Are Determined
Although there are many staging systems, the TNM staging system, created by The American Joint Committee on Cancer (AJCC), is the most common and useful. This particular staging system looks to include information about:
- Location of the primary (original) tumor.
- Tumor size and extent of tumors.
- Lymph node involvement (whether or not the cancer has spread to the nearby lymph nodes).
- Presence or absence of distant metastasis (whether or not the cancer has spread to distant areas of the body).
This information is collected and assigned a letter or number to describe the tumor (T), node (N), and metastasis (M) categories.
- T describes the original (primary) tumor.
- N tells whether the cancer has spread to the nearby lymph nodes.
- M tells whether the cancer has spread (metastasized) to distant parts of the body
These letter assignments are then combined into an overall stage:
- Stage 0: This stage indicates that the cancer has remained in the same place it started. It is “in situ.”
- Stage 1: Often called early-stage cancer, the tumor is localized. It has not spread deeply to other tissues or the lymph nodes.
- Stages 2 and 3: These cancers are larger than stage 1 and may have spread to the lymph nodes but not to other parts of the body.
- Stage 4: This type of cancer, called advanced or metastatic cancer, has spread to distant parts of the body.
Related reading: Pay Attention to Your Lymph Nodes for Cancer Signs.
What You Can Do After a Cancer Diagnosis
In addition to getting all the specifics about your type of cancer, one of the best things you can do after a diagnosis is to get prepared. This should include creating a system of your own that will help you stay organized with your personal information and any questions you may have regarding your care.
At Rocky Mountain Cancer Centers, we want you to have the best outcome possible. To help us better help you, we encourage you to keep track of notes, medications, side effects, and any other details that will help us understand how you are responding to your recommended cancer treatments. Keeping organized documentation will help ensure that your RMCC cancer care team stays aware of your progress and your needs at all times. And, as always, we are here to address any questions or concerns you may have along the way.
To schedule a consultation with one of our oncology specialists, please find the RMCC location that is most convenient for you to request an appointment. We also offer second opinions, allowing you to discuss the treatment plan you were given and compare it to how our team would approach your treatment. These are often covered by insurance and it’s a good idea to do this when possible before you choose your team and your treatment path.