Читать книгу Overcome the Challenges of Cancer Care - M. D. Rosenberg - Страница 23

Staging depends on the type of cancer, but we generally define staging in two areas: clinical versus pathological stage. This is often confusing to patients.

Clinical stage is determined using information from a physical exam and scans. A pathological stage is determined after surgery (we’ll talk about pathological stage in chapter 6, where we discuss surgery).

So if you’ve had a biopsy, isn’t your stage a pathological stage? No! The biopsy just helps confirm what type of cancer a person has. The pathological stage is classified after a surgical procedure on the cancer—that is, after removing the mass or lymph nodes.

As part of a first diagnosis, a patient gets a clinical stage. The clinical stage is broken up into three parts: T (tumor), N (lymph nodes), and M (metastasis). This is called the TNM staging system, and it’s used across a range of cancers. The criteria vary depending on the cancer type, but here are the general principles:

 T considers the size of the tumor.

 N looks at the number of lymph nodes into which the cancer has spread (see chapter 2 for more on lymph nodes).

 M considers whether the cancer has spread, or metastasized, to other organs (liver, lungs, and so on).

Each one of these groups gets a number. For example, if a woman has a 2.5-centimeter mass in the breast and one lymph node is involved, her stage is T2N1M0.

Most often, when doctors talk about cancer with patients, we do not discuss the TNM. Doctors often only discuss the final stage or group the patient falls into, which you’ll read about in the next section.