The growth and advancement of cancer is described with the help of a system called 'staging and grading'. The grading system helps describe the number and size of tumors. Staging of cancer helps know how much the cancer has spread within the body (if at all). Cancer staging helps design proper treatment for the patient. Doctors can assess the effectiveness of the treatment by ordering certain tests and by checking the stage and grade of the cancer, after the treatment. Staging helps estimate the person's prognosis too.
As you know, cancer cells grow abnormally and they do not die (like other normal cells) when they should. Surgical removal of cancer is possible (with a few exceptions), if cancer is detected at early stages like 'carcinoma in situ ' or 'stage zero'. Thus, early detection of cancer helps cure the disease. Sometimes, amputation of a limb or surgical removal of an internal organ like uterus, ovaries, etc. helps extend the life expectancy of the patient. The patient and the family members are happy when they know that the cancer is in its preliminary stage. Unfortunately, stage 4 cancer survival rate is very low, it's around 5 years only (in most cases). This is because it is difficult to remove cancer at an advanced stage and we have not yet come up with a cure for cancer. Let us take a look at the factors that determine staging of cancer:
Factors that Determine Staging of Cancer
- The size of the tumor
- How deeply the tumor has penetrated
- How many lymph nodes it has metastasized to. Spreading of cancer to distant organs is termed as 'metastasis'.
- Whether it has invaded adjacent organs
- Whether it has spread to distant organs
The following section presents information on stages of cancer.
Cancer Staging
Stage 0 Cancer: This stage is known as carcinoma in situ. You might have heard about the Pap smear test that helps detect early evidence of cervical cancer or carcinoma in situ. This test has helped save millions of women from dying due to cervical cancer.
Stage 1 Cancer: Tumors usually are smaller than two centimeters. Lymph glands are not affected by cancer cells and the cancer is localized to one part of the body (where it originated) and has not spread anywhere else.
Stage 2 Cancer: The tumors generally measure two to five centimeters. The lymph nodes may be affected. The cancer is still considered as localized as it has not spread any further. The cancer is said to be locally advanced.
Stage 3 Cancer: The tumors appear fairly large, generally more than five centimeters in size. Nearby lymph nodes are seen affected by cancer cells. Many times, it is difficult to differentiate between stage II and stage III cancer. Allotting certain stage to the cancer depends mainly on the type of the cancer.
Stage 4 Cancer: During this stage, tumors can be of any size. Nearby lymph nodes are already affected and the cancer has spread to (metastasized to) other organs or regions throughout the body. Development of secondary cancer is noticed during this stage. Cancerous cells invade distant organs and lymph nodes. As the cancer spreads into the bones or liver, the patient suffers from serious health complications and dysfunction of various organs. Some cancers are invasive (grow and spread fast) while some take years to develop. Overall physical and mental health of the patient also determines whether the cancerous cells would be under control after the treatment or they would invade distant organs. It is difficult to remove metastasized cancer.
Life expectancy for fourth stage cancer is very low. People diagnosed with small cell lung cancer (SCLC), may not live for more than 2 to 4 months, if left untreated. With treatment, only about 5 to 10% people with SCLC, are seen to live up to 5 years. Those with non-small cell lung cancer, only 10 to 15% people are observed to live up to 5 years. According to the available statistics, lung cancer in fourth stage allows 32% of patients to live for one year; and only 2% patients with fourth stage lung cancer live longer than 5 years. These statistics should not be used to predict the life expectancy of a particular patient; because these numbers are obtained by studying large groups of patients (from different races and backgrounds). The numbers are useful for doctors and researchers, as they study the effectiveness of various treatments or medications.
Treatment for Advanced Stage Cancer
Physical exam, biopsy, blood tests, liver functioning test, urine test, CT scan, MRI scan, PET scan and surgery helps know the location of the cancer, the size and number of tumor/s, and whether the cancer has spread. When the doctor tells a person that he has cancer that has reached the fourth stage, it can be very shocking and frightening for the patient. But for the doctor, it is necessary to know the stage. Staging helps him determine the most appropriate treatment for the patient. No cancer would respond to an improper treatment. The treatment varies according to the specific type of cancer, patient's age, overall physical health, mental stability, stage and grade, symptoms, etc. The doctor knows whether chemotherapy and radiation therapy would work or not. Painkillers that help reduce the pain and discomfort are usually prescribed. Palliative treatment forms the main part of stage four cancer treatment. Prognosis of cancer in fourth stage depends on the type of the cancer and age, will power and determination of the patient.
Staging is based on the information that doctors collect through various tests and surgeries, and on how the cancer develops. Cancer cells in the tumors enter the lymphatic system or the bloodstream and reach other organs. They start growing in other organs. Though it is scary to hear about the development of cancer, one should never lose hope; as there have been people who have survived a stage 4 cancer and lived to tell the tale. I am a cancer patient and believe me, with positive thinking and self-confidence, you can lead a quality life. You should deal with cancer confidently. Be in the company of cheerful friends and stay away from people who drain you off. It is highly beneficial to read stories of cancer patients as you can draw strength and inspiration from them.
