In the world of cancer patients and caregivers, sentences such as 'Betty's got third stage blood cancer' or 'Rajeev's cancer is in the last stage' are quite common. But in order to fully comprehend the extent & severity of cancer across stages, it becomes important to understand cancer staging in a strictly medical context. In this piece, the team at Onco.com tries to do exactly that.

Cancer Staging - What Does It Mean?

Within the medical community, Cancer Staging refers to the standardised process used in determining the extent of the disease (cancer) in the body. It helps doctors plan all necessary treatments for a patient, as per standard recommendations.

It includes:

• The severity of cancer, based on the magnitude of tumour/tumours in the primary site of origin.
• The extent to which cancer has spread in the body (both locally and distant from the site of origin, to other organs).

How Does Cancer Staging Help?

Cancer Staging & Prognosis

Cancer Staging helps doctors in determining the right prognosis for every patient. What this means, is that with accurate Cancer Staging, a doctor can design a unique treatment plan for each individual patient.

Cancer Staging & Medical Collaboration/Panel Considerations

This format of standardized staging also creates a common language for doctors to effectively communicate about a specific cancer case, and allows many doctors to collaborate on single treatment course. For example, in Onco.com's multidisciplinary panel consultations, such staging allows the entire panel to be on the same page as far as the patient's condition is concerned.

Cancer Staging & New Treatments

Understanding what stage a patient's cancer is in, helps doctors in defining appropriate treatment strategy and clinical trials that may be useful to specific patients.

What Are The Different Types Of Cancer Staging?

There are three main types of Cancer Staging, which are widely in use within the field of oncology.

  1. Clinical Staging: This tells us how much cancer there is based on physical examination, imaging tests, and biopsies.

  2. Pathological Staging: For patients who have had tumour-removal surgery. This combines the results of clinical staging (physical exam, imaging tests) and surgical results.

  3. Restaging: Applicable in cases of relapse/recurrence. This gives the extent of disease if the cancer relapses and helps in identifying the best treatment routes.

Factors That Determine Cancer Staging

While several factors are involved in determining a specific stage for a specific patient, the primary considerations include:

Site of the Primary Tumour
• Tumour size and local extent
• Status of Regional Lymph Nodes being affected
Metastasis (involvement of distant organs): (Yes/No)

What Tests/Reports Are Needed For Accurate Cancer Staging?

Oncologists need to review and evaluate multiple test results before confirming what stage a patient's cancer is in. Such tests include:

Physical Examinations - Physical tests often reveal the primary site and an indicative size of the tumor(s), and can indicate whether the cancer has spread to the lymph nodes, or other organs.

Imaging Tests (X-rays/CT scans/MRI/PET CT scans) - These reveal the exact location of the cancer, the exact size of the tumor, status of metastasis, and whether the tumour is operable.

Laboratory Tests/Pathological Tests - These are useful in testing blood, bone marrow, urine and other fluids & tissues retrieved from a patient's body. Different tumour markers can be tested in blood which may point towards status of disease especially to denote recurrence after treatment. Pathology reports can help in the diagnosis of cancer, as well as the stage in blood cancers.

Surgical Reports/ Biopsy Sample Reports - Biopsy tissue taken from intact tumours help in establishing diagnosis of cancer prior to treatment. Samples removed during surgery are studied to determine the size and appearance of a tumor, local extent, and other pathological features helpful in determining the pathological stage. Surgical reports also help doctors in understanding whether further treatment (Radiation Therapy, Immunotherapy Treatments, Hormone Therapy, etc) is necessary to eliminate the cancer threat.

TNM Cancer Staging

The TNM Cancer Staging System was developed jointly by the American Joint Committee on Cancer and the Union for International Cancer Control(UICC). It classifies cancer stages into numerically identifiable categories, and is the most commonly used staging system by medical professionals today. This system of classification was developed with the objective of staging cancers in a standardized numeric format.

Thanks For Reading!

This is a part of our series of articles on "Is Cancer Curable?".

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