Staging
After a diagnosis of cancer is made, the disease will be staged.
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Staging of the disease reflects the spread of cancer, both extension locally and to other areas of the body.
Cancer is staged for two reasons.
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To establish a more complete picture and therefore, to aid in a decision for appropriate management.
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To establish a prognosis.
The staging of each cancer is done differently, but they largely follow the Stage 1 – 4 system. The stage is determined by imaging +/- surgical excision and tissue examination under a microscope.
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Stage 1: The cancer cells have not invaded deeper into the surrounding tissue or spread around the body.
Stage 2/3: Spread more extensively locally, invading the surrounding tissues and involving the lymph nodes.
Stage 4: The cancer has spread to a distant site, unrelated to the primary tumour. This is often referred to as metastatic disease, with each separate cancer site called a “met” (short for metastases).
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An oncologist will treat a patient differently depending on the stage of their cancer. If it is stage 1, surgical excision alone may suffice, if the microscopic investigation shows clean borders.
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If it is stage 4, surgical excision alone will not be sufficient as the cancer has spread. Sometimes the primary/largest tumour will still be removed, before commencing chemo/immunotherapy and/or radiotherapy.
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As mentioned, the staging is also helpful in terms of establishing a prognosis. Your oncologist may use the term "5-year survival rate”. Essentially, this is the percentage of patients that have survived their cancer five years on from diagnosis depending on the stage and tumour subtype.
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Some patients would prefer not to know such numbers, which is absolutely their right. But many find it helpful, in understanding their chance of a positive outcome. These numbers are established by studying thousands of cases with the same cancer, stage, and received treatment as the prospective patient.