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Understanding Cancer Staging Terminology

Understanding which stage your cancer is in is important because different stages carry different prognoses. The failure to diagnose cancer at an early stage can make treatment more difficult or impossible as the cancer progresses. In many cases, the failure to diagnose cancer at a stage where it is treatable can cost patients years off of their lives and great pain and suffering.

Cancer staging describes the extent to which an individual’s cancer has progressed. Staging takes into account the extent to which the original, or primary, tumor has grown and also the extent to which the cancer has spread to different areas of the body.

How Does Cancer Grow?

In order to better understand how and why cancers are grouped into “stages,” some basic understanding of cancer terminology is required. Cancer is, most simply, caused by an abnormality in the genetic material of transformed cells. These abnormalities can be caused by outside sources like tobacco smoke, radiation, or chemicals, or they may have a genetic source.

Cancer cells divide and grow uncontrollably to form a tissue mass. This mass is referred to as a growth or a tumor. If the tumor continues to grow untreated, it can invade other organs and tissues or break away and enter the bloodstream or lymphatic system.

When the cancer cells enter the bloodstream or lymphatic system, the cancer is able to spread from the primary infection site and form new tumors on other organs. The formation of new tumors is called metastasis.

TNM Cancer Staging

There are many different types of cancer staging systems. One of the most common is called the “TNM system.” This system evaluates the cancer on three levels: extent of the tumor (T), extent of the spread to the lymph nodes (N), and presence of metastasis (M). Each letter is then followed by a number.

Primary Tumor (T)

TX Primary tumor cannot be evaluated

T0 There is no evidence of a primary tumor

Tis Carcinoma in Situ (an early cancer which has not spread to any neighboring tissue)

T1 – T4 These describe the size and extent of the primary tumor

Regional Lymph Nodes (N)

NX Regional lymph nodes cannot be evaluated

N0 No cancer has been found in the lymph nodes

N1 – N3 These describe the size and extent of spread to lymph nodes

Distant Metastasis (M)

MX Distant metastasis cannot be evaluated

M0 Cancer has not spread to other parts of the body

M1 Cancer has spread to different parts of the body

How Does TNM Help Me Understand My Prognosis?

Because each type of cancer is different, the TNM categories do not translate identically into treatment options. In general, physicians categorize tumors into five stages.

Stage 0. Carcinoma in Situ. Cancer has not spread past the layer of cells where it began

Stage I – Stage III. These stages indicate how far the diseases have progressed. The greater the tumor size and the spread of the cancer to lymph nodes or other organs, the higher the number.

Stage IV. These cancers have spread to other organs.

The National Cancer Institute has promulgated a list of treatment summaries for each of the types of adult cancer and pediatric cancer.

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