Cancer Staging: What It Means for You and Why It Is Important
After a patient receives their cancer diagnosis, before any treatment is provided, the next thing that happens is for the cancer to be staged – the process used to determine how much cancer exists and where it is located. This “staging” period can take a few days or even weeks and living in the uncertainty of what is to come next can be a scary experience for a patient who just heard the words, “You have cancer.”
As difficult, frustrating and fear inducing that it can be to wait to get the cancer staged, an accurate assessment of a patient’s individual cancer is necessary for creating any kind of plan to move forward into treatment. Doctors need every piece of information they can get to provide the best treatment.
There are several different factors that go into providing a patient with accurate staging information, but most cancers fall under four to five different stages of progression:
Stage 0 – often called “carcinoma in situ,” where abnormal cells have been detected, but they have not spread to any adjacent tissue; considered highly curable;
Stage I – a small amount of cancer cells with minimal spread and no involvement of lymph nodes; often referred to as “early stage” cancer and confined to one small area;
Stages II and III – the cancer detected is larger in size and has grown into nearby tissue or lymph nodes;
Stage IV – the cancer has spread into different parts of the body; often referred to as advanced or metastatic cancer.
The cancer stage is determined by using a number of tools including physical examinations, imaging tests like CT scans, ultrasounds, PET scans, MRIs or endoscopies, and biopsies for solid tumors. It is the scheduling and waiting for results to be read which is what lengthens the process for staging.
There are other measures and factors that go into staging and some of them are specific to the type of cancer being staged. Cancer of a woman’s reproductive organs use the FIGO system of staging, brain cancers typically are not staged, as most do not metastasize to other parts of the body, leukemia is not staged, and lymphomas use a different type of staging. Most other types of cancer follow what is called the TNM system, referring to tumors, nodes, and metastasis. Each of these markers have a coordinating number measure from 0-4, depending on size and spread.
A few more considerations that go into this process and impact a final staging determination include:
Grade – this measure looks at cells to determine if they are low grade (look more like normal cells and tend to grow more slowly) or high grade (look abnormal and grow more quickly and spread more easily);
Location – depending on where a tumor is located, its treatment may change or become more complicated;
Tumor markers – these are signs in a cancer patient’s blood or urine that may become elevated, depending on the type of cancer present; and
Genetic markers – the specific DNA of cancer cells may determine their likelihood to spread and best treatment options.
It is also important to note that staging generally remains the same, even if treatment is successful in eliminating cancer from the body. Not only does accurate staging help determine treatment method and modality, but it can also provide some general indication of prognosis and how successful treatment may be. Another value of staging cancer is that it provides a known foundation for doctors to communicate and collaborate with one another on patients and treatment – staging, in essence, becomes the language used between researchers and clinicians to create better and more effective cancer treatments for patients.
Srilata Gundala, MD, a hematologist/oncologist and the founder of Hope & Healing Care Centers in Lombard and Hinsdale, Illinois relies on cancer staging to provide her patients with the best and most promising treatment methods available to them. Even so, she is sensitive to what a difficult process staging can be for her patients, “My patients are experiencing one of the hardest periods of their lives. The staging process, while so necessary, adds stress to an already stressful situation. It is important for all my patients to ask questions and know that I will take the time to answer them and help them understand their cancer, their treatment, and, if asked, the likelihood of its success. These are difficult conversations to have, but trusting the information available to me is the best way I can answer questions to the best of my ability.”
If you want to know more about the cancer staging process, the American Cancer Society provides good information accessible to all. You can find it here.
Written By: Sheila Quirke, MSW
Reviewed By: Srilata Gundala, MD
