The stage of cancer is the process of determining the extent to which cancer has grown by spreading and spreading. The contemporary practice is to assign numbers from I to IV for cancer, with me being isolated and IV cancer being a cancer that has spread to the extent of what the assessment measures. The stage generally takes into account the size of the tumor, whether it has invaded adjacent organs, how many regional (nearby) lymph nodes that have spread to (if any), and whether it has appeared in more distant locations (metastasizes).
Video Cancer staging
TNM staging system
The stage of cancer can be divided into clinical and pathological stages. In TNM (Tumor, Node, Metastasis) system, the clinical stage and pathological stage are denoted by a small "c" or "p" before the stage (eg, cT3N1M0 or pT2N0). This staging system is used for most forms of cancer, except for brain tumors and haematological malignancies.
- The clinical stage is based on all available information obtained before surgery to remove the tumor. This stage may include information about tumors obtained by physical examination, blood tests, radiological examination, biopsy, and endoscopy.
- The pathological stage adds additional information obtained by microscopic examination of the tumor by the pathologist after surgery is removed.
Because they use different criteria, the clinical and pathological stages are often different. Pathological staging is usually considered more accurate because it allows direct examination of the tumor as a whole, in contrast to clinical stages limited by the fact that information is obtained by making indirect observations of tumors that are still inside the body. However, clinical staging and pathological staging often complement each other. Not every tumor is treated with surgery, so pathological staging is not always available. Also, sometimes surgery is preceded by other treatments such as chemotherapy and radiation therapy that shrink the tumor, so the pathological stage may underestimate the true stage.
Maps Cancer staging
Considerations
Correct determination is important because care (especially the need for preoperative therapy and/or for adjuvant treatment, surgery level) is generally based on this parameter. Thus, incorrect performances will lead to improper treatment.
For some common cancers, the staging process is well defined. For example, in cases of breast cancer and prostate cancer, doctors can routinely identify that the cancer is earlier and have a lower risk of metastasis. In such cases, professional organizations of medical specialists recommend the use of PET scans, CT scans, or bone scans because studies show that the risk of obtaining such procedures outweighs the possible benefits. Some of the problems associated with overtesting include patients who receive invasive procedures, overuse of medical services, get unnecessary radiation exposure, and experience misdiagnosis.
Pathologist
Pathological staging, in which a pathologist examines parts of the tissue, can be very problematic for two specific reasons: visual discretion and random sampling of tissues. "Visual discretion" means being able to identify single cancer cells that mix with healthy cells on the slide. Surveillance of a single cell can mean wrong and lead to a serious and unexpected spread of cancer. "Random sampling" refers to the fact that the lymph nodes are selected by the patient and a random sample is examined. If cancerous cells present in the lymph nodes occur not present in the tissue slices seen, staging is wrong and improper care may occur.
Latest research
New, highly sensitive staging methods are being developed. For example, the mRNA for GCC (guanylyl cyclase c), only present in the luminal aspect of the bowel epithelium, can be identified using molecular screening (RT-PCR) with high sensitivity and precision. The presence of GCC in other tissues of the body is a colorectal metaplasia. Due to its high sensitivity, RT-PCR screening for GCC greatly reduces estimates that are too low to stage disease. The researchers hope that staging with this precision level will lead to more precise care and better prognosis. Furthermore, researchers hope that this same technique can be applied to other tissue-specific proteins.
System
Staging systems are specific for each type of cancer (eg, breast and lung cancer), but some cancers do not have a staging system. Although competing staging systems still exist for some types of cancer, the universally accepted staging system is from UICC, which has the same definition of the individual category as AJCC.
The staging system may differ between diseases or special manifestations of a disease.
Blood
- Lymphoma: using Ann Arbor staging
- Hodgkin's disease: follows a scale from I to IV and may be further indicated by A or B, depending on whether the patient is asymptomatic or has symptoms such as fever. This system is known as the "Cotswold System" or "Ann Arbor Modified Mapping System".
Solid
For solid tumors, TNM is by far the most commonly used system, but has been adapted for several conditions.
- Breast cancer: In the classification of breast cancer, staging is usually based on TNM, but staging in I-IV can be used as well.
- Cervical and ovarian cancer: the "FIGO" system has been adopted into the TNM system. For premalignant dysplastic changes, a CIN (cervical intraepithelial neoplasia) assessment system is used.
- Colon cancer: initially consists of four stages: A, B, C, and D (Dukes staging system). More recently, bowel cancer staging is indicated either by the original A-D stage or by TNM.
- Kidney cancer: using TNM.
- Laryngeal cancer: Using TNM.
- Liver cancer: Using TNM.
- Lung cancer: using TNM.
- Melanoma: TNM is used. Also notable are the "Clark levels" and "Breslow depth" which refers to the microscopic depth of tumor invasion ("Microstaging").
- Prostate cancer: TNM is almost universally used.
- Testicular cancer: using TNM together with blood serum marker marker (TNMS).
- Non-melanoma skin cancer: using TNM.
- Bladder cancer: using TNM.
Group level breakdown
The Grouping of the Overall Stages is also called the Determination of Roman Numbers. This system uses numbers I, II, III, and IV (plus 0) to describe the development of cancer.
- Stage 0 : carcinoma in situ.
- Stage I : Cancer is localized to one part of the body. Stage I cancer can be surgically removed if it is small enough.
- Phase II : locally advanced cancer. Second stage cancer can be treated with chemotherapy, radiation, or surgery.
- Stage III : Cancer is also advanced locally. Whether the cancer is defined as Phase II or Stage III may depend on a specific type of cancer; for example, in Hodgkin's Disease, Phase II shows the affected lymph nodes on only one side of the diaphragm, whereas Stage III shows the affected lymph nodes above and below the diaphragm. Specific criteria for Phase II and III are therefore different according to the diagnosis. Stage III can be treated with chemotherapy, radiation, or surgery.
- Stage IV : cancer often spreads, or spreads to other organs or throughout the body. Stage IV cancer can be treated with chemo, radiation, or surgery.
In the TNM system, the cancer can also be called repeated, meaning that it has reappeared after being remissioned or after all visible tumors have been removed. Scatter can be localized, meaning that it appears in the same location as the original, or remote, meaning that it appears in different parts of the body.
Migration stage
Stage migration describes changes in the distribution of stages in certain cancer populations caused by changes in the staging system itself or technological changes that allow more sensitive tumor detection to spread and are therefore more sensitive in detecting the spread of disease (eg, the use of MRI scans). Stage migration can cause strange statistical phenomena (for example, the phenomenon of Will Rogers).
References
External links
- "Staging: Questions and Answers" at the National Cancer Institute
Source of the article : Wikipedia
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