Cancer Stage and Grade
CCC419
Jan 9th, 2019
Dr. Anindita Chakrabarty
Cancer Grading and Staging
ü The stage of a cancer describes the size of a tumor and how far it has spread from
where it originated
ü The grade describes the appearance of the cancerous cells
ü Staging and grading the cancer will allow the doctors to determine its size, whether
it has spread and the best treatment options
Cancer Stages
Different types of staging systems are used for different types of cancer
Below is an example of one common method of staging:
ü stage 0 – indicates that the cancer is where it started (in situ) and hasn't spread
ü stage I – the cancer is small and hasn't spread anywhere else
ü stage II – the cancer has grown, but hasn't spread
ü stage III – the cancer is larger and may have spread to the surrounding tissues
and/or the lymph nodes
ü stage IV – the cancer has spread from where it started to at least one other body
organ-also known as "secondary" or "metastatic" cancer
Stages of Colorectal Cancer
Stages of Lung Cancer
TNM (Tumor-Node-Metastasis) Classification
ü One of the most widely used staging systems-accepted by the Union of the
International Cancer Control (UICC) and the American Joint Committee on Cancer
(AJCC)
ü Based on the size and/or extent (reach) of the primary tumor (T), amount of spread to
nearby lymph nodes (N) and the presence of metastasis (M) or secondary tumors
formed by the spread of cancer cells to the other parts of the body
ü A number is added to each letter to indicate the size and/or extent of the primary
tumor and the degree of cancer spread
TNM and Staging
ü Breast cancer classified as T3 N2 M0 refers to a large tumor that has spread outside
the breast to nearby lymph nodes but not to other parts of the body
ü Prostate cancer T2 N0 M0 means that the tumor is located only in the prostate and has
not spread to the lymph nodes or any other part of the body
ü For many cancers, TNM combinations correspond to one of five stages that differ
among different cancers-bladder cancer T3 N0 M0 is stage III, whereas colon cancer
T3 N0 M0 is stage II
ü Most types of cancer have TNM designations, but some don’t; cancers of the brain
and spinal cord are staged according to their cell type and grade
ü Different staging systems are also used for leukemias and lymphomas
What Types of Tests are done for Staging
ü Physical exams
ü Imaging studies-X-rays, CT (computed tomography) scans, PET (positron emission
tomography) scans, MRI (magnetic resonance imaging) scans
ü Laboratory tests with blood, urine, other fluids looking for cancer biomarkers
ü Pathology of tumor biopsy and cytology on blood sample
ü Surgical reports
Cancer Grades
The grade of a cancer depends on what the cells look like under a microscope
In general, a lower grade indicates a slower-growing cancer and a higher grade
indicates a faster-growing one
The grading system that’s usually used is as follows:
ü grade I – cancer cells that resemble normal cells and aren't growing rapidly
ü grade II – cancer cells that don't look like normal cells and are growing faster than
normal cells
ü grade III – cancer cells that look abnormal and may grow or spread more
aggressively
Different cancers have different grading system-determined by pathology reports on
tumor biopsy samples
