What Is Cancer Staging

Cancer staging is the process that allows your doctor to describe the severity of your cancer based on the size of your primary tumor and whether that cancer has spread. Staging is important in:

  • Helping your doctor plan appropriate treatment
  • Determining prognosis
  • Identifying potentially effective clinical trials
  • Allowing your care team and researchers to communicate more specifically

Stages of Cancer

Staging is determined through a combination of physical exams, imaging procedures, laboratory tests, pathology reports and surgical reports. Staging helps determine the best course of treatment.

We describe cancers using staging systems. Some staging systems cover many types of cancer, while others are specific to one type. The elements considered in most staging systems are:

  • Location of the primary tumor
  • Tumor size and number of tumors
  • Whether cancer has spread to lymph nodes
  • How closely cancer cells resemble normal tissue (cell type and tumor grade)
  • Presence of absence of metastasis

Most cancers are described as Stage 0 through IV, IV being the most severe. These stages break down as follows:

Stage 0             Early cancer that is present in only the layer of cells in which it began (referred to as carcinoma in situ)

Stages I-III       The higher the stage, the more extensive the cancer, which could mean greater tumor size or
that the cancer has spread to nearby lymph nodes or organs adjacent to the primary tumor.

Stage IV           The cancer has spread to another organ.

Some cancers may be classified differently. Cancers of the brain and spinal cord, for example, are classified according to their cell type and grade, and different staging systems exist for many blood and bone marrow cancers, such as lymphoma.

What types of tests are used to determine stage?

Tests are used to determine staging often depend on the type of cancer.

  • During a physical exam, the doctor will look, feel and listen for anything unusual. Physical exams may show the location and size of the tumor and help determine whether the cancer has spread to the lymph nodes or other tissues or organs.
  • Various imaging studies allow the doctor to see inside the body and are helpful in determining stage. X-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans and positron emission tomography (PET) scans can show the location of the cancer, the size of the tumor, and whether the cancer has spread.
  • Laboratory tests may be used to examine the blood, urine and other fluids and tissues taken from the body. These tests may reveal symptoms that can tell doctors more about the cancer type, size and location.
  • Pathology reports may include information about the tumor size, its spread, type and grade. A biopsy—the removal and examination of tissue—may supplement the pathology report and Cytology reports—a study of your cells—also describe findings from the examination of cells in body fluids.
  • Following biopsy, a surgical report details findings. These reports describe the size and appearance of the tumor and often include observations about lymph nodes and nearby organs.

Cancer & Hematology Centers of Western Michigan’s 17 physicians provide care in 8 locations in Western Michigan. Having been in practice for more than 30 years, our doctors have seen and treated nearly every type of cancer.

Types of cancer fall under broader categories, including:

  • Carcinoma, which begins in the tissue or skin lining or covering internal organs. Subtypes of carcinoma include adenocarcinoma, basal cell carcinoma, squamous cell carcinoma and transitional cell carcinoma.
  • Sarcoma, which begins in bone, cartilage, fat, muscle, blood vessels, or any other connective or supportive tissue.
  • Leukemia, which starts in blood-forming tissue like bone marrow and causes large numbers of abnormal blood cells to be produced and released into the bloodstream.
  • Lymphoma and myeloma, which begin in the cells of the immune system.
  • Central Nervous System cancers, which begin in the tissues of the brain and spinal cord.

Below is information on the top sixteen cancer types. For details on cancer types not listed here, please visit: http://www.cancer.gov/cancertopics/types/alphalist