Understanding Cancer: Deciphering the Complexity of Diagnosis and Staging

There is a high chance that you have heard different things about cancer and you must have known that cancer is complex. In fact, some people just know the word cancer, but do not know that its morphology is very complex, same is its grades or stages. One thing that we all know even when we are not Oncologist, is that cancer is complex.

Although people who are not at the receiving end do not know much, people who are in directly or indirectly facing cancer need to understand everything the oncologist say the alphabets and numbers they mention as it will help understand the type of cancer they have but for this to happen, a person needs to be diagnosed.

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Diagnosing cancer has to do with different tests and imaging, ranging from blood work, x-rays, and so on. After a cancer is identified, the next thing to do is to find out to what extent the cancer has gone and this is where staging comes in. With staging, we look at how big the cancer is and how to treat the cancer. To do this, more x-rays, Contrast CT scan, Biopsies, physical examinations.

Let me guess, you believe stage 4 cancer is a death sentence and it is worse than stage 1 cancer. Well, there are so many ways to categorize cancers and let me tell you this for free that cancer staging doesn't start at 1, actually it starts at 0, and Stage 0 cancer doesn't mean No cancer as you would imagine, it means the cancer is still "In situ" (meaning at its original place), and hasn't spread.

That about stage 0 cancer, other stages are 1 to 4 which is used to identify the cancer according to how they spread. With stage 1 cancer also known as Localized cancer, nearby cells already have a glimpse of the cancer but then, the cancer is still tiny and is located in the vicinity where it originated. When looking at Stage 2 cancer, the cancer is now big but still in the tissue where it originated. When a cancer is at stage 3 or Regional, the cancer has grown bigger than in stage 2 and has began to migrate to nearby tissues and lymph nodes. With Stage 4 cancer, Metastasis has occurred where the has spread to other organs in the body.

That said, you might be wondering if Cancer has a stage 5, well there is a cancer that has a stage 5 and it is known as Wilms Tumor which is a type of kidney tumor in children. With Wilms tumor, when both kidneys have the tumor, it is referred to as Stage 5. Wilms tumor isn't the only type of cancer with a more complex staging, cancers like Prostrate Cancer in stage 2 can also have Stage 2A when the cancer is on one side of the prostrate or stage 2B when the cancer is on both sides of the prostrate.

Back to when I mentioned that you might think that all stage 4 cancers are death sentence, well not all stage 4 cancers are created equally. Cancers like Hodgkin's lymphoma in stage 4 is treatable and people with this cancer have 70% to 85% survival rate of 5 years. When I say that Stages might talk about spread but also touch on severity. Stage 2 pancreatic cancer has a low survival rate of 44% after 3 years.

Okay! that said, I know you are familiar with the staging I just mentioned but what about the TNM staging which emphasizes on size specifically. With T, it means the cancer is still in its origin, N will be used to describe the nearby lymph nodes while M refers to Metastasis to other organs. When there are cancers that is stages ts "Tis" in the TNM staging, it means the Cancer is In situ the original cell, when it is comes with a "X" suffix such as TX or NX, it means that the cancer is in its original tissue, or Nearby Tissue but cannot be accessed.

Asides from the letter, it can also be accompanied by numbers from 0 to 4 which is used to identify the invasiveness and size of the tumor. While T can go up to 4, N can go up to 3, and with M it has 0 and 1, where 0 means the tumor hasn't Metastasized, while 1 means it has. In cases where the cancer has metastasized to more than 1 organ, it would be regarded with the alphabet b for instance M1b.

When it comes to the aggressiveness of the cancer, cancer grading is used. When the cancer cell looks similar to the normal cells still having the features of the normal cells, it is regarded as grade 1. When the cancer cells doesn't look like the healthy cells, in a case where they are moderately differentiated, it is regarded as Grade 2, and when the cancer cells look different from the normal cells, being poorly differentiated, and are very aggressive, they are referred to as grade 3.

Navigating the intricacies of cancer diagnosis and staging underscores the multidimensional nature of this disease. Understanding the alphabet soup of cancer terminology empowers patients and healthcare professionals alike in devising personalized treatment strategies and fostering hope in the face of adversity. Unless you are a medical doctor yourself, or a medical practitioner that has affiliation to the lab, it will be difficult to understand what is written in your test results. So it is advisable to always give it to your doctor to interpret what is written there.

Read More

https://www.cancercenter.com/diagnosing-cancer/diagnostic-imaging/ct-scans
https://www.ncbi.nlm.nih.gov/books/NBK553187/
https://www.nih.gov/news-events/nih-research-matters/annual-chest-x-rays-dont-cut-lung-cancer-deaths
https://cancer.ca/en/cancer-information/what-is-cancer/stage-and-grade/grading
https://cancer.ca/en/cancer-information/cancer-types/wilms-tumour/staging
https://www.cancer.org/cancer/types/breast-cancer/about/types-of-breast-cancer/dcis.html
https://www.cancer.org/cancer/diagnosis-staging/staging.html
https://www.cancer.org/cancer/types/breast-cancer/treatment/treatment-of-breast-cancer-by-stage.html
https://cancer.ca/en/cancer-information/what-is-cancer/how-cancer-starts-grows-and-spreads
https://www.cancer.net/cancer-types/breast-cancer/stages
https://www.cancerresearchuk.org/about-cancer/hodgkin-lymphoma/survival
https://www.nhs.uk/common-health-questions/operations-tests-and-procedures/what-do-cancer-stages-and-grades-mean/
https://www.cancerresearchuk.org/about-cancer/pancreatic-cancer/survival