House Call: Cancer Stages: Understanding the Basics

From OncoLog, October 2007, Vol. 52, No. 10

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Cancer Stages: Understanding the Basics

Going through the process of cancer diagnosis can be a dizzying ordeal, with a lot of information to process during an emotional time. Afterward, patients who have learned they have “stage III breast cancer” or “stage I melanoma” may still be unsure about what that means. Or family and friends may want to get a better understanding of what it means when a loved one has been diagnosed with “stage IV colon cancer.”

An important summary

Stage 0 A very early cancer that is only in the layer of cells where it started; also called carcinoma in situ.

Stage I A small tumor that hasn’t spread beyond the tissues where it arose; the cancer is localized.

Stage II A larger tumor that may have pushed on or entered nearby structures.

Stage III A more advanced cancer that has spread (metastasized) to nearby lymph nodes; also called a regional cancer.

Stage IV A cancer that has spread to organs distant from the original site; also called distant metastasis.

Cancer staging is an important part of diagnosis and is done to determine, as closely as possible, how far the cancer has spread when it is diagnosed. In addition to a patient’s physical exam and tumor biopsy results, the doctor may get information from imaging tests such as computed tomography scans, X-rays, or bone scans, as well as from blood work and sometimes surgery. Staging is done for most types of cancer, except for leukemias and related diseases (which use different prognostic systems).

The information obtained through the staging process helps doctors determine the patient’s treatment plan and prognosis. The stage is an easy-to-understand summary of what doctors have learned through the staging process, such as the size of the cancer and whether it has spread to other sites in the body.

The five stages

Most cancers can be categorized into one of five basic stages. The higher the number, the more advanced the cancer is. Each type of cancer has individual guidelines, but in general, the information in the shaded boxes applies.

Some types of cancer, such as those of the breast and pancreas, are further categorized within the stages—for instance, stage IIa or stage IIIb. For more detailed staging information specific to each cancer type, go to www.cancer.gov/cancertopics/pdq/adulttreatment. Select a type of cancer and then click on the “Stages” link.

It’s also helpful to know that when a cancer has spread to another part of the body, the type of cancer doesn’t change. For example, a breast cancer that has spread to the bones is considered a metastasized breast cancer, not a bone cancer.

-- Dianne Witter

For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.

Other articles in OncoLog, October 2007 issue:

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