Stage refers to the extent of your cancer, such as how large the tumor is and if it has spread. Knowing the stage of your cancer helps your doctor
- understand how serious your cancer is and your chances of survival
- plan the best treatment for you
- identifyclinical trials that may be treatment options for you
A cancer is always referred to by the stage it was given at diagnosis, even if it gets worse or spreads. New information about how a cancer has changed over time is added to the original stage. So the stage doesn't change, even though the cancer might.
How Stage Is Determined
To learn the stage of your disease, your doctor may order x-rays, lab tests, and other tests or procedures. See the section on How Cancer Is Diagnosed to learn more about these tests.
Systems That Describe Stage
There are many staging systems. Some, such as the TNM staging system, are used for many types of cancer. Others are specific to a particular type of cancer. Most staging systems include information about
- where the tumor is located in the body
- the size of the tumor
- whether the cancer has spread to nearby lymph nodes
- whether the cancer has spread to a different part of the body
The TNM Staging System
The TNM system is the most widely used cancer staging system. Most hospitals and medical centers use the TNM system as their main method for cancer reporting. You are likely to see your cancer described by this staging system in your pathology reportunless there is a different staging system for your type of cancer. Examples of cancers with different staging systems include brain and spinal cord tumors and blood cancers.
In the TNM system
- The T refers to the size and extent of the main tumor. The main tumor is usually called the primary tumor.
- The N refers to thenumber of nearby lymph nodes that have cancer.
- The M refers to whether the cancer has metastasized. This means that the cancer has spread from the primary tumor to other parts of the body.
When your cancer is described by the TNM system, there will be numbers after each letter that give more details about the cancer—for example, T1N0MX or T3N1M0. The following explains what the letters and numbers mean.
Primary tumor (T)
- TX: Main tumor cannot be measured.
- T0: Main tumor cannot be found.
- T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b.
Regional lymph nodes (N)
- NX: Cancer in nearby lymph nodes cannot be measured.
- N0: There is no cancer in nearby lymph nodes.
- N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.
Distant metastasis (M)
- MX: Metastasis cannot be measured.
- M0: Cancer has not spread to other parts of the body.
- M1: Cancer has spread to other parts of the body.
Other Ways to Describe Stage
The TNM system helps describe cancer in great detail. Butfor many cancers, the TNM combinations are grouped into five less-detailed stages. The following chart shows how your doctor or nurse may describe your cancer.
| Stage | What it means |
|---|
| Stage 0 | Abnormal cells are present but have not spread to nearby tissue. Also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer. |
| Stage I, Stage II, and Stage III (may also be written as Stage 1, Stage 2, and Stage 3) | Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues. |
| Stage IV (may also be written as Stage 4) | The cancer has spread to distant parts of the body. |
The higher the number, the more advanced the cancer is. Letters and numbers are often used after the first number to describe the cancer in more detail. For instance, Stage 2 prostate cancer may be further divided into 2A, 2B, or 2C.
Another staging system that is used for all types of cancer groups cancer into one of five main categories. This staging system is more often used by cancer registries than by doctors. But you may still hear your doctor or nurse describe your cancer in one of the following ways.
- In situ—Abnormal cells are present but have not spread to nearby tissue.
- Localized—Cancer is limited to the place where it started, with no sign that it has spread.
- Regional—Cancer has spread to nearby lymph nodes, tissues, or organs.
- Distant—Cancer has spread to distant parts of the body.
- Unknown—There is not enough information to figure out the stage.
To learn more about staging for your type of cancer, see the PDQ® cancer treatment summaries for adult and childhood cancers.
FAQs
The TNM Staging System
- The T refers to the size and extent of the main tumor. The main tumor is usually called the primary tumor.
- The N refers to the number of nearby lymph nodes that have cancer.
- The M refers to whether the cancer has metastasized.
Stage 4 cancer is not always terminal. It is usually advanced and requires more aggressive treatment. Terminal cancer refers to cancer that is not curable and eventually results in death. Some may refer to it as end stage cancer.
Why would a cancer not be staged? ›
Not all cancers are staged. For example, leukemias are cancers of the blood cells and therefore typically have spread throughout the body by the time they are found. Most types of leukemias aren't staged the way cancers that form tumors are.
How do you interpret cancer staging? ›
In general, a higher stage refers to more advanced cancer.
- Stage 0: Abnormal cells are present, but have not spread.
- Stage I, II, III: Refer to size of tumor and how much cancer has spread to lymph nodes.
- Stage IV: Disease has spread to other organs and tissues.
Stage 4 cancer has spread from its original location to distant parts of the body. It's sometimes referred to as metastatic cancer. This stage may be diagnosed years after the initial cancer diagnosis and/or after the primary cancer has been treated or removed.
Can stage 4 cancer go back to stage 3? ›
1. The stage assigned to your cancer at the time of diagnosis does not change, even if you later go into remission or the disease grows worse.
Which cancer kills the fastest? ›
Pancreatic cancer is aggressive. It often kills quickly and causes painful symptoms like: Stomach pain.
What's the longest you can live with Stage 4 cancer? ›
Stage 4 cancer usually has spread to multiple places in the body, meaning you can live only a few weeks or a few months. In rare cases, some people may survive for several months or even a year with stage 4 cancer, with or without treatment.
Has anyone been saved from stage 4 cancer? ›
Stage IV lung cancer survivor: Targeted therapy and surgery left me cancer-free. As a retired firefighter and combat veteran, I've been in some pretty tough situations. But the hardest thing I've ever done was sit my four children down and tell them I had stage IV lung cancer.
Which is worse, basal cell or squamous cell? ›
Basal cell carcinoma is the most common type . Both of these non-melanoma skin cancers cause growths on the skin's surface. These growths typically do not spread to other parts of the body. However, squamous cell carcinoma has a slightly higher risk of spreading.
In general, the time frame for receiving biopsy results is usually between one to two weeks. However, it can be as short as a few days or, in some complex cases, it may take several weeks.
Which cancer is most likely to come back? ›
The chance of recurrence is higher for:
- People treated for a childhood cancer.
- Adult survivors of Hodgkin lymphoma.
- Glioblastoma, a type of brain cancer.
- Some types of soft tissue sarcoma.
- Cancers of the bladder and pancreas.
- Cancers caused by tobacco use.
Advanced cancer usually means that there is a lot of cancer or it has spread (is a later stage). Terminal cancer usually means the cancer cannot be controlled and is likely to be the cause of someone's death. Some advanced cancers can be treated to control their growth or spread, while others are terminal.
What is the aggressive cancer scale? ›
A higher number means that the cancer is more aggressive and more likely to spread. The Gleason score is determined by adding the two most common grades seen in a sample by the pathologist. Grades range from 3 (least aggressive) to 5 (most aggressive) and scores range from 6 (least aggressive) to 10 (most aggressive).
How long to live if cancer is in the lymph nodes? ›
What is the survival rate when cancer spreads to the lymph nodes? This will depend on the type of cancer, the treatment available, and other factors. For people with breast cancer, the 5-year survival rate when cancer is only in the breast is 99% . If cancer spreads to the lymph nodes, the rate is 86%.
What tests are done to determine the stage of cancer? ›
Imaging tests used in diagnosing cancer may include a computerized tomography (CT) scan, bone scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, ultrasound and X-ray, among others. Biopsy. During a biopsy, your doctor collects a sample of cells for testing in the laboratory.
What do doctors look for when diagnosing cancer? ›
Lab tests - These check the levels of certain chemicals in the blood, urine and other body fluids—a level that's too high or too low may be a sign of cancer. Imaging tests - Images of internal organs may be examined for signs of cancer.
Which of the following are used to identify the three types of cancer staging? ›
The TNM staging system. The TNM staging system stands for Tumour, Node, Metastasis. The system uses letters and numbers to describe the cancer.
What factors determine the stage of cancer? ›
Clinical staging determines how much cancer there is based on physical examination, imaging tests, and biopsies of affected areas. Pathological staging can be determined when a patient has surgery to remove a tumor. Pathological staging combines the results of both the clinical staging with the surgical results.
