The stage of a cancer is a descriptor (usually numbers I to IV) of how much the cancer has spread. The stage often takes into account the size of a tumor, how deep it has penetrated, whether it has invaded adjacent organs, if and how many lymph nodes it has metastasized to, and whether it has spread to distant organs. Staging of cancer is important because the stage at diagnosis is the biggest predictor of survival, and treatments are often changed based on the stage. When normal cells are damaged beyond repair, they are eliminated by apoptosis. ... Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...

Clinical staging and pathological staging

Cancer staging can be divided into a clinical stage and a pathologic stage. In the TNM (Tumor, Node, Metastasis) sytem, clinical stage and pathologic stage are denoted by a small 'c' or 'p' before the stage, e.g. cT3N1M0 or pT2N0. TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ...

• Clinical stage is based on all of the available information obtained before a surgery to remove the tumor. Thus, it may include information about the tumor obtained by physical examination, radiologic examination, and endoscopy.
• Pathologic stage adds additional information gained by examination of the tumor microscopically by a pathologist.

Because they use different information, clinical stage and pathologic stage are often different. Pathologic staging is usually considered the "better" or "truer" stage because it allows direct examination of the tumor and its spread, contrasted with clinical staging which is limited by the fact that the information is obtained by making indirect observations at a tumor which is still in the body. However, clinical staging and pathologic staging should complement each other. Not every tumor is treated surgically, so sometimes pathologic staging is not available. Also, sometimes surgery is preceded by other treatments such as chemotherapy and radiation therapy which shrink the tumor, so the pathologic stage may underestimate the true stage. Pathology (in ancient Greek pathos = feeling, pain, suffering and logos = discourse or treatise, i. ... Chemotherapy is the use of chemical substances to treat disease. ... Clinac 2100 C accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...

Systems of staging

Staging systems are specific for each type of cancer (e.g. breast cancer and lung cancer). Some cancers, however, don't have a staging system. Often competing staging sytems exist for the same type of cancer; however, the universally-accepted staging system is that of the UICC, which has merged its staging system with that of the AJCC.

Systems of staging may differ between diseases or specific manifestations of a disease. (In cases where the main Wikipedia article has a specific section on staging, that section has been linked below.)

Blood

• lymphomas: uses Ann Arbor staging

• Hodgkin's Disease#Staging: follows a scale from I-IV and can be indicated further by an A or B, depending on whether a patient is unsymptomatic or has symptoms such as fevers. It is known as the "Cotswold System" or "Modified Ann Arbor Staging System". [1]

Lymphoma is a general term for cancers that develop in the lymphatic system. ... Ann Arbor staging is the staging system for lymphomas, both in Hodgkins disease and non-Hodgkins lymphoma. ... Hodgkins disease is a type of lymphoma described by Thomas Hodgkin in 1832, and characterized by the presence of Reed-Sternberg cells. ...

Solid

For solid tumors, TNM is by far the most commonly used system, but it has been adapted for some conditions.

• breast_cancer#Staging: Uses TNM [2]

• cervical cancer#Staging: uses "FIGO" (similar to TNM). For premalignant dysplastic changes, the CIN (cervical intraepithelial neoplasia) grading system is used. [3]

• colon_cancer#Staging: originally consisted of four stages: A,B,C,and D (the "Duke Staging System"). More recently, colon cancer staging is indicated either by the original A-D stages or by TNM. [4]

• kidney cancer: uses TNM [5]

• cancer of the larynx: Uses TNM [6]

• liver cancer#Staging_and_prognosis: uses Stages I-IV [7]

• lung cancer: uses TNM [8] or [9]

• malignant_melanoma#Staging: TNM used. Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion ("Microstaging"). [10]

• prostate cancer staging: outside of US, TNM almost universally used. Inside US, Jewett-Whitmore somtimes used. [11].

• skin cancer: uses TNM [12]

Breast cancer is cancer of breast tissue. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Cervical cancer is a malignancy of the cervix. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Cervical intraepithelial neoplasia, or CIN, is the abnormal growth of precancerous cells in the cervix. ... Diagram of the stomach, colon, and rectum Colorectal cancer includes cancerous growths in the colon, rectum and appendix. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Renal cell carcinoma, a form of kidney cancer that involves cancerous changes in the cells of the renal tubule, is the most common type of kidney cancer in adults. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Cancer of the larynx also may be called laryngeal cancer. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Hepatocellular carcinoma (HCC, also called hepatoma) is a primary malignancy (cancer) of the liver. ... The incidence of lung cancer is highly correlated with smoking. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Melanoma is a malignant tumour of melanocytes. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... Prostate cancer staging is the process by which physicians evaluate the spread of prostate cancer. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ... In medicine (dermatology), there are several different types of cancer referred to under the general label of skin cancer. ... TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ...

Overall stage grouping

Overall Stage Grouping is also referred to as Roman Numeral Staging. This system uses numerals I,II,III, and IV to describe the progression of cancer.

• Stage I cancers are localized to one part of the body.
• Stage II cancers are locally advanced, as are Stage III cancers. Whether a cancer is designated as Stage II or Stage III can depend on the specific type of cancer; for example, in Hodgkin's Disease, Stage II indicates affected lymph nodes on only one side of the diaphragm, whereas Stage III indicates affected lymph nodes above and below the diaphragm. The specific criteria for Stages II and III therefore differ according to diagnosis.
• Stage IV cancers have often metastisized, or spread to other organs or througout the body.

Within the OSG system, a cancer may also be designated as recurrent, meaning that it has appeared again after being in remission or after all visible tumor has been eliminated. Recurrence can either be local, meaning that it appears in the same location as the original, or distant, meaning that it appears in a different part of the body.

TNM staging

TNM Staging is used for solid tumors, and is an acronym for the words Tumor, Nodes, and Metastases. Each of these criteria is separately listed and paired with a number to indivate the TNM stage. A T1N2M0 cancer would be a cancer with a T1 tumor, N2 involvement of the lymph nodes, and no metastases (no spreading through the body). TNM Classification of Malignant Tumours (TNM) is the system developed and maintained by the International Union Against Cancer (UICC) to maintain consensus on one globally recognised standard for categorising cancer. ...

• Tumor (T) refers to the primary tumor and carries a number of 0 to 4.
• N represents regional lymph node involvement and can also be ranked from 0 to 4.
• Mestastasis is represented by the letter M, and is 0 if no metastasis has occurred or 1 if metastases are present.

Stage migration

Stage migration is the artificial change in the stage of a cancer produced by either a change in the staging system itself or a change in technology which allows more sensitive detection of tumor spread (e.g. the use of MRI scan). Stage migration can lead to curious statistical phenomena. See Will Rogers phenomenon. The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ... The Will Rogers phenomenon is the apparent paradox obtained when moving an element from one set to another set raises the average values of both sets. ...

External links

• "Staging: Questions and Answers" at the National Cancer Institute