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Staging is the process of finding out how much cancer there is in the body and where it is located.
Stage 0 carcinoma in situ. Stage I cancers are localized to one part of the body. Stage II cancers are locally advanced. Stage III cancers are also locally advanced. 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 metastasized, or spread to other organs or throughout the body.
Tis T1 T2 T3 T4 N0 N1
In situ, non-invasive (confined to epithelium) Small, minimally invasive within primary organ site Larger, more invasive within the primary organ site Larger and/or invasive beyond margins of primary organ site Very large and/or very invasive, spread to adjacent organs No lymph node involvement Nearby lymph node involvement
N2 N3 M0 M1
Regional lymph node involvement More distant lymph node involvement No distant metastases Distant metastases present
TX means the tumor can't be measured. T0 means there is no evidence of primary tumor (it cannot be found). Tis means that the cancer cells are only growing in the most superficial layer of tissue, without growing into deeper tissues. This is also known as in situ cancer or pre-cancer. The numbers T1, T2, T3, and T4 describe the tumor size and/or level of invasion into nearby structures. The higher the T number, the larger the tumor and/or the more it has grown into nearby tissues.
The N category describes whether or not the cancer has spread into nearby lymph nodes; refers to the number and location of lymph nodes involved. NX means the nearby lymph nodes cannot be evaluated. N0 means nearby lymph nodes do not contain cancer. The numbers N1, N2, and N3 describe the size, location, and/or the number of lymph nodes involved. The higher the N number, the more the lymph nodes are involved. The M category tells whether there are distant metastases (spread of cancer to other parts of body); refers to metastasis. MX means metastasis can't be evaluated. M0 means that no distant metastases were found. M1 means that distant metastases were found (the cancer has spread to distant organs or tissues). 2. Treatment of Neoplasms Treatment also varies based on the type of tumor, whether it is benign or malignant, and its location. If the tumor is benign (meaning it has no potential to spread) and is located in a "safe" area where it will not cause symptoms or affect the function of the organ, sometimes no treatment is needed. Sometimes benign tumors may be removed for cosmetic reasons, however. Benign tumors of the brain may be removed because of their location or harmful effect on the surrounding normal brain tissue. If a tumor is malignant, treatments include:
Surgery Radiation therapy Chemotherapy A combination of these methods immunotherapy Biologic or targeted therapy. If the cancer is in one location, the goal of treatment is usually to remove the tumor with surgery. If the tumor has spread to local lymph nodes only, sometimes these can also be removed. If all of the cancer cannot be removed with surgery, the options for treatment include radiation and chemotherapy, or both. Some patients require a combination of surgery, radiation, and chemotherapy. However, lymphoma is rarely treated with surgery. Chemotherapy and radiation therapy are most often used for treating lymphoma.
References : Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, eds. American Joint Committee on Cancer Staging Manual. 7th ed. New York, NY: Springer; 2010. Yarbro CH, Frogge MH, Goodman M, Groenwald SL, eds. Cancer Nursing Principles and Practice. 5th ed. Sudbury, MA: Jones and Bartlett Publishers, Inc. 2000.