How long does cancer staging take

Doctors may recommend a local treatment, such as surgery or radiotherapy if your cancer is just in one place. This could be enough to get rid of the cancer completely. A local treatment treats only an area of the body.

But you might need treatment that circulates throughout the whole body if your cancer has spread. These are called systemic treatments and include:. You can read more about the different types of cancer treatment. Sometimes doctors aren't sure if a cancer has spread to another part of the body or not. So they look for cancer cells in the lymph nodes near the cancer. Cancer cells in these nodes is a sign that the cancer has started to spread.

This is often called having positive lymph nodes. It means that the cells have broken away from the original cancer and got trapped in the lymph nodes. But it isn't always possible to tell if they have gone anywhere else. Adjuvant treatment means having treatment in addition to the main treatment for the primary tumour. Doctors suggest adjuvant treatment if you have cancer cells in the lymph nodes.

An example of this is having chemotherapy after surgery. The aim of adjuvant treatment is to kill any cancer cells that have broken away from the primary tumour. There are 2 main types of staging systems for cancer. These are the TNM system and the number system. T refers to the size of the cancer and how far it has spread into nearby tissue — it can be 1, 2, 3 or 4, with 1 being small and 4 large.

N refers to whether the cancer has spread to the lymph nodes — it can be between 0 no lymph nodes containing cancer cells and 3 lots of lymph nodes containing cancer cells. M refers to whether the cancer has spread to another part of the body — it can either be 0 the cancer hasn't spread or 1 the cancer has spread. So for example a small cancer that has spread to the lymph nodes but not to anywhere else in the body may be T2 N1 M0.

Or a more advanced cancer that has spread may be T4 N3 M1. Sometimes doctors use the letters a, b or c to further divide the categories. For example, stage M1a lung cancer is a cancer that has spread to the other lung.

The M describes metastasis, which is the spread of cancer to other parts of the body. When a practitioner uses the TNM staging system to describe a cancer, they use numbers after each letter to give details about the cancer. For instance, an individual with stage 1 colorectal cancer may be assigned a grade of T1, N0, M0. This indicates that the tumor may have grown into a muscle layer in the gastrointestinal tract, but has not spread to lymph nodes or other parts of the body.

What is the difference between clinical staging and pathological staging? Pathological staging is based on what is discovered during surgery. Staging can also be done after an individual has received other treatments prior to surgery, such as chemotherapy, radiation therapy, or immunotherapy. This type of staging, known as the post-therapy stage, may be done for some cancers because treatment prior to surgery helps shrink the tumor so it can be removed.

What cancers are not staged? Not all cancers are staged, and some are staged differently than others. Most blood cancers, including leukemia, are not staged. This is because, at the time of diagnosis, the leukemia cells are already circulating throughout the body.

Doctors describe leukemia as either active or in remission. Brain tumors are also not staged. This is because, while they may spread to other parts of the nervous system, they rarely spread to lymph nodes. Instead, the tumor cells are graded from 1 to 4 to indicate how different they look from normal, healthy cells.

Grade 4 cells are the most abnormal. Small cell lung cancer is typically described as either limited stage or extensive disease. Limited stage means the cancer is limited to the chest. Extensive disease means it has extended outside the chest, which requires a different treatment approach.

Will restaging a cancer change the initial stage? When a cancer is staged again after the first staging, it is referred to as restaging. Many times, the same tests that were performed when the cancer was initially diagnosed such as imaging tests, physical exams, and biopsies are done again. The stage assigned at diagnosis remains the most important one to record for statistics like survival rates.

What is a cancer grade, and how is it different from a cancer stage? Cancer cells that look most like normal cells are low-grade tumors. Lower-grade cancers are generally less aggressive and have more favorable prognoses.

The cancer's stage tells you where a cancer is located and its size, how far it has grown into nearby tissues, and if it has spread to nearby lymph nodes or other parts of the body. Before starting any cancer treatment, doctors may use physical exams, imaging scans, and other tests to determine a cancer's stage. Staging may not be completed until all the tests are finished.

Staging helps your doctor plan the best treatment. This may include choosing a type of surgery and whether or not to use chemotherapy or radiation therapy.

Knowing the cancer stage lets your entire health care team talk about your diagnosis in the same way. Staging of a cancer can be done at different times in a person's medical care. Here are some information on when and how staging is done. You will notice that these descriptions refer to the "TNM category.

Clinical staging. Clinical staging is staging that is done before any treatment begins. Your doctor uses information from physical exams, your medical history, and any x-rays, imaging, scans, or diagnostic tests that you had.

They will also use the results of any biopsy that has been done of the cancer, lymph nodes, or other tissue. Clinical staging helps you and your doctor plan the initial steps in your treatment. Clinical staging is indicated with a small "c" before the TNM category. Pathological staging. Pathological staging is based on the same information as clinical staging, plus any new information gained during surgery if surgery was the first treatment for the cancer.

Pathological staging is indicated with a small "p" before the TNM category. Post-therapy staging. Post-therapy staging is used in cases where surgery is not the first treatment, but other treatments are given before surgery. These treatments can include radiation therapy or drug treatments like chemotherapy, immunotherapy, or hormone therapy. These treatments may be used before surgery to shrink the tumor to make surgery easier. It can also help doctors learn how well treatments work for the cancer to plan further treatment.

Post-therapy staging is indicated with a "y" before the TNM category. When doctors determine the stage of the cancer using the TNM system see below , every cancer should be staged with clinical staging. After surgery or initial treatments before surgery, pathological staging and post-therapy staging should be used as well. Clinical staging is very important to help plan initial treatment, but pathological staging or post-therapy staging give the most information.

This can help your health care team understand your prognosis. Doctors use the TNM staging system for most types of cancer. The TNM system uses letters and numbers to describe the tumor T , lymph nodes N , whether or not the cancer has spread or metastases M. Each letter and number tell you something about the cancer.

The specific definitions for each category are different for each type of cancer that is staged using this system. Learn more specific staging information for each type of cancer.

Tumor T : The letter T and the number after it describe the tumor by answering these questions:. The letter T is followed by a letter, number, or combination of letters after it. This gives additional information about the tumor. The different letters and numbers that may see include:. TX means that there is no information about the tumor or it cannot be measured. Tis refers to a tumor "in situ. It has not spread to any surrounding tissue.

T1-T4 describe the size and location of the tumor, on a scale of 1 to 4. A larger tumor or a tumor that has grown deeper into nearby tissue will get a higher number. For some types of cancer, the T stage can be broken down into subcategories for even more detail. This is noted with a lowercase letter, like an "a" or "b", such as "T2b". What these letters mean depends on the type of cancer.

A lowercase "m" can also be used to show that there are multiple tumors. Node N : The letter N and the number after it describe if cancer has affected the lymph nodes. The lymph nodes are small, bean-shaped organs that help fight infection. They are a common spot where cancer first spreads. This part of the staging system answers these questions:. Lymph nodes near where the cancer started are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

The N category only refers to lymph nodes near the cancer regional lymph nodes.