Cancer Staging And Grading

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CANCER STAGING and GRADING



The process of finding the extent or severity of a patients Cancer.



describes the severity of a person’s cancer based on the extent of the original (primary) tumor and whether or not cancer has spread in the body.

CANCER STAGING



Staging helps the doctor plan the appropriate treatment.



The stage can be used to estimate the person’s prognosis.



Knowing the stage is important in identifying clinical trials that may be suitable for a particular patient.



Staging helps health care providers and researchers exchange information about patients; it also gives them a common terminology for evaluating the results of clinical trials and comparing the results of different trials.

IMPORTANCE of STAGING

   



Site of the primary tumor. Tumor size and number of tumors. Lymph node involvement (spread of cancer into lymph nodes). Cell type and tumor grade* (how closely the cancer cells resemble normal tissue cells). The presence or absence of metastasis.

COMMON ELEMENTS of CA STAGING

CLINICAL STAGING  This is an estimate of how much cancer there is based on the physical exam, imaging tests (x-rays, CT scans, blood tests, etc.), and tumor biopsies. 



a key part of deciding the best treatment to use and the baseline used for comparison when looking at the cancer's response to treatment.

TYPES of STAGING

PATHOLOGIC STAGING  Pathological staging (also called surgical staging) relies on information obtained during surgery. 



gives the health care team more precise information that can be used to predict treatment response and outcomes (prognosis).

TYPES of STAGING

THE TNM GRADING SYSTEM



Developed by the American Joint Committee on Cancer (AJCC) as a tool for doctors to stage different types of cancer based on certain standards.



In the TNM system, each cancer is assigned a T, N, and M category.

TNM STAGING



Primary Tumor



Describes the size or direct extent of the original (primary) tumor.



The tumor size is usually measured in centimeters (2 and 1/2 centimeters is about 1 inch) or millimeters (10 millimeters = 1 centimeter).

T Category

Tx

Primary tumor cannot be evaluated.

T0

No evidence of primary tumor

Tis

Carcinoma in situ (CIS; abnormal cells are present but have not spread to neighboring tissue; although not cancer, CIS may become cancer and is sometimes called preinvasive cancer)

T1

Tumor is 2 cm (3/4 of an inch) or less across.

T2

Tumor is more than 2 cm but not more than 5 cm (2 inches) across.

T3

Tumor is more than 5 cm across.

T Category Tumor of any size growing into the chest wall or skin. This

T4

includes inflammatory breast cancer.



Nodal Involvement



Describes the extent of spread of the tumor cells to the lymph nodes



Describes whether or not the cancer has spread into nearby lymph nodes.

N Category

NX

Regional lymph nodes cannot be evaluated

N0

Means nearby lymph nodes do not contain cancer.

N1

Cancer has spread to 1 to 3 lymph node(s).

N2

Cancer has spread to 4 to 9 lymph nodes.

N3

Cancer has spread to 10 or more lymph nodes.



Distant Metastases



tells whether there are distant metastases (spread of cancer to other parts of body).

M Category

MX

Metastasis can't be evaluated

M0

No distant metastases were found

M1

Distant metastases were found (the cancer has spread to distant organs or tissues).

M Category



Reflects how abnormal cancer cells look under the microscope.



refers to the classification of the tumor cells.



Grading systems seek to define the type of tissue from which the tumor originated and the degree to which the tumor cells retain the functional and histologic characteristics of the tissue of origin.

CANCER Grading

GX

Cancer cells cannot be determined

G1

Cancer cells are well differentiated

G2

Cancer cells are moderately differentiated

G3

Cancer cells are poorly differentiated

G4

Cancer cells are undifferentiated

CANCER Grading



Once the values for T, N, and M have been determined, they are combined, and an overall stage is assigned.



For most cancers, the stage is a Roman numeral from I to IV.



Sometimes stages are subdivided as well, using letters such as A and B

STAGE Grouping



Stage 0 is carcinoma in situ for most cancers. This means the cancer is at a very early stage, is only in the area where it first developed, and has not spread. Not all cancers have a stage 0. Stage I cancers are the next least advanced and often have a good prognosis (outlook for survival). As the stage number goes up the cancers are more advanced (bigger and more widespread), but in many cases they can still be treated.

In Situ

Abnormal cells are present only in the layer of cells in which they developed.

Localized

Cancer is limited to the organ in which it began, without evidence of spread.

Regional

Cancer has spread beyond the primary site to nearby lymph nodes or organs and tissues.

Distant

Cancer has spread from the primary site to distant organs or distant lymph nodes.

Unknown

There is not enough information to determine the stage.

Surveillance, Epidemiology, and End Results Program (SEER)

THE END.. :3

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