Cancer Spread In The Lymph Nodes
Sometimes doctors aren’t sure if a cancer has spread to another part of the body or not. So they look for cancer cells in the lymph nodes near the cancer.
Cancer cells in these nodes is a sign that the cancer has started to spread. This is often called having positive lymph nodes. It means that the cells have broken away from the original cancer and got trapped in the lymph nodes. But it isn’t always possible to tell if they have gone anywhere else.
Why Does Cancer Stage Matter
Staging helps your doctor plan the best treatment. This may include choosing a type of surgery and whether or not to use chemotherapy or radiation therapy. Knowing the cancer stage lets your entire health care team talk about your diagnosis in the same way.
Doctors can also use staging to:
Understand the chance that the cancer will come back or spread after the original treatment.
Help forecast the prognosis, which is the chance of recovery
Help determine which cancer clinical trials may be open to you.
See how well a treatment worked
Compare how well new treatments work among large groups of people with the same diagnosis
About Author: Lisa Coon
Lisa Coon is a Writing Coordinator for OSF HealthCare, where she has worked since August 2016. A Peoria native, she is a graduate of Bradley University with a degree in journalism. Previously, she worked as a reporter and editor at several newspapers in Iowa and Illinois.She lives in Groveland with her husband and son. In her free time she likes to cook, bake and read. She freely admits that reality TV is a weakness, and she lives by the quote, The beach is good for the soul.
Also Check: Metastatic Breast Cancer Access To Care Act
Stage 4 Testicular Mesothelioma
Testicular mesothelioma is the rarest type of this cancer, with about 100 cases documented in medical literature that affect less than 1% of all patients. As with the pericardial type, testicular mesothelioma has no official staging system and may not be defined as stage 4.
Due to its rarity, doctors diagnose testicular mesothelioma as an advanced disease in most cases. Testicular mesothelioma can spread to distant lymph nodes and pelvic tissue in its later stages.
Stage 4 Cancer Symptoms
The symptoms of metastatic cancer depend on the type of cancer. In some cases, there are no symptoms at all, so it’s possible to have stage 4 cancer and not know it.
Most of the time, a cancer that reaches stage 4 affects not only the part of the body where it originated, but the areas where it has spread to as well.
|Common Symptoms of Metastatic Cancer
|When cancer spreads to:
Stage 4 cancer also can cause more general symptoms, such as extreme fatigue and lack of energy. Some people become so tired and weak they have trouble doing everyday things. They may even need help with getting dressed or other routine tasks.
Hearing your doctor call a liver tumor “breast cancer” may sound strange. But stage 4 cancer is diagnosed based on where the original cancer is located, not where it has spread. So, breast cancer that has spread to the liver will be called stage 4 breast cancer with liver metastasisnot stage 4 liver cancer.
Also Check: What To Expect After Chemo
How Are Tumors Removed
Removing a tumor is a common type of cancer surgery. This may also be called a “resection” or “excision.” Your doctor usually takes out the tumor and some of the healthy tissue near it. The tissue around the tumor is called the margin. Tumor removal generally requires a larger incision, or cut, than a biopsy.
Treatment Options For Stage 4 Cancer
Stage 4 cancer is challenging to treat, but treatment options may help control the cancer and improve pain, other symptoms and quality of life. Systemic drug treatments, such as targeted therapy or chemotherapy, are common for stage 4 cancers.
Often, a clinical trial may be an option, offering new treatments to help you fight stage 4 cancer.
Below are the prevailing treatment options for the five most common cancers.
Treatment of stage 4 breast cancer: For cancer that has spread beyond the breast and nearby lymph nodes, systemic drug treatments are typically used. These include:
- Hormone therapy
They may be used alone or in combination, and they may also be determined by the hormone receptor and the HER2 status of the cancer.
Surgery and radiation may be treatment options in specific cases to help improve symptoms caused by a growing tumor, not to get rid of the cancer. The tumor may be removed with surgery or shrunk by radiation therapy if, for example, its:
- Blocking a blood vessel
- Causing a wound
- Affecting the spinal cord
Treatment of stage 4 lung cancer: In general, stage 4 lung cancer is also treated with systemic drug therapies.
Stage 4 lung cancer that has spread to one distant area tends to be treated differently than lung cancer that has spread more widely. For stage 4A cancers, treatment tends to focus on the one site where the cancer has spread.
- Hormone therapy
- Hormone therapy combined with chemotherapy
- Radiation therapy, possibly followed by hormone therapy
Also Check: Targeted Therapy For Breast Cancer
What Is The Reason For Staging Cancer
Healthcare providers stage cancer for several reasons:
- Cancer is a complicated disease. Healthcare providers take a team approach to treating cancer. Staging systems give healthcare providers shared guidelines for diagnosing cancer and a common language to share what theyve learned.
- Cancer treatment is evolving. The staging process gives healthcare providers a shared starting point that remains the same even as treatment options change.
- Most people who have cancer want to know what to expect, including the prognosis or expected outcome. Staging cancer gives healthcare providers a way to tap other healthcare providers experience with specific cancer types and stages. Then, they use that experience to develop a prognosis.
- Staging cancer supports clinical trials and research that improves cancer treatment. Some clinical trials and research use information about people who have the same cancer type and stage. If people want to participate in a clinical trial, healthcare providers use cancer stages to identify potential trials for people to consider.
Types Of Staging Systems
There are 2 main types of staging systems for cancer. These are the TNM system and the number system.
The systems mean that:
- doctors have a common language to describe the size and spread of cancers
- doctors can compare treatment results between research studies
- different hospitals and clinics have standard treatment guidelines
Some blood cancers or lymph system cancers have their own staging systems.
Read Also: Why Does Cancer Come Back
What Are The Four Stages Of Cancer
Most cancers have four stages. The specific stage is determined by a few different factors, including the size and location of the tumor:
- Stage I: Cancer is localized to a small area and hasnt spread to lymph nodes or other tissues.
- Stage II: Cancer has grown, but it hasnt spread.
- Stage III: Cancer has grown larger and has possibly spread to lymph nodes or other tissues.
- Stage IV: Cancer has spread to other organs or areas of your body. This stage is also referred to as metastatic or advanced cancer.
Though stages I through IV are the most common, there is also stage zero. This earliest phase describes cancer that is still localized to the area in which it started. Cancers that are still in stage zero are usually easily treatable and are considered pre-cancerous by most healthcare providers.
Other Factors That Can Affect A Cancer’s Stage
For some cancers, the values for T, N, and M arent the only things that determine the stage. Some other factors that may be taken into account include:
Grade: For most cancers, the grade is a measure of how abnormal the cancer cells look under the microscope. This is also called differentiation. Grade can be important because cancers with more abnormal-looking cells tend to grow and spread faster.
The grade is usually assigned a number, with lower numbers used for lower grade cancers.
- In low-grade cancers, the cancer cells look fairly normal. In general, these cancers tend to grow slowly and often have a better outlook.
- In high-grade cancers, the cancer cells look more abnormal. High-grade cancers often tend to grow quickly, so they may need different treatments than low-grade cancers.
Even when the grade doesnt affect a cancers stage, it might still affect a persons outlook and/or treatment.
Cell type: Cancers in some parts of the body can start in different types of cells. Because the type of cancer cell can affect treatment and outlook, it can be a factor in staging. For example, cancers of the esophagus are mainly either squamous cell cancers or adenocarcinomas. Squamous cell esophageal cancers are staged differently from esophageal adenocarcinomas.
A persons age: For some types of cancer, such as thyroid cancer, a persons age at the time of diagnosis can affect their outlook, so it is taken into account when assigning a stage.
Read Also: Lower Abdominal Pain Radiating To Back
Common Symptoms Of Late
- Shortness of breath
- Severe weight loss or anorexia
- General feeling of discomfort
A typical cancer symptom in stage 4 mesothelioma is cachexia, a metabolic syndrome involving weight loss, muscle atrophy , weakness and appetite loss. Stage 4 mesothelioma can cause blood problems such as high platelet counts and low red blood cell counts .
Doctors often diagnose mesothelioma in later stages because symptoms generally do not appear until stage 3 or 4. Mesothelioma symptoms mimic many other common cancers and illnesses and require a specialized oncologist to confirm a diagnosis.
Free Mesothelioma Nutrition Guide
What Is Second Stage Of Cancer
Stage 2 cancer refers to larger tumors or cancers that have grown more deeply into nearby tissue. In this stage, the cancer may have spread to the lymph nodes, but not to other parts of the body. At Cancer Treatment Centers of America® , our cancer experts recognize that stage 2 cancer is a complex disease.
Don’t Miss: How Does Breast Cancer Look Like
A Change In Cancer Stage
For the most part, he said, the stage of a cancer doesnt change. The exception, however, is when cancer has been diagnosed as an early stage, like Stage 1, and years later, there is a cancer recurrence.
Another way the stage of a cancer can change is by down staging, Dr. Shaukat said. For example, in breast cancer, a patient may undergo chemotherapy to make the tumor more operable.
Four things to know about cancer staging:
Cancer staging, Dr. Shaukat said, is used to help patients get the appropriate care they need and to be informed, active participants in their cancer care.
How Many Stages Of Cancer Are There
Most cancers are assigned one of four stages, ranging from 1 to 4, with the lowest stage describing early and small tumors and the higher stages categorizing cancers that have progressed and spread. Doctors may use Roman numerals for each stage instead of numbers, but they mean the same thing. Stages 1, 2, 3 and 4 may be written as I, II, III and IV.
- Stage 1, or early-stage or localized cancer: The cancer has not infiltrated deeply into nearby tissue, nor has it spread to lymph nodes or locations away from the primary tumor.
- Stage 2, or early locally advanced cancer: Tumor cells have spread deeper into neighboring tissue, but not to distant sites in the body.
- Stage 3, or advanced-stage or locally advanced cancer: The cancer has grown more deeply into neighboring tissue and spread to lymph nodes but hasnt spread to distant sites in the body.
- Stage 4, or metastatic or advanced cancer: Cancer cells have spread beyond nearby tissue and into lymph nodes and parts of the body, including organs, potentially far from the original site.
What Other Factors Are Used In Cancer Staging
For some cancer types, factors other than the TNM categories can be included in the cancer’s stage. They may include:
Grade. The grade describes how much cancer cells look like healthy cells. A pathologist will look at the cancer cells under a microscope. A pathologist is a doctor who specializes in evaluating cells, tissues, and organs to diagnose disease. They will compare the cancer tissue with healthy tissue. Healthy tissue often contains many types of cells groups together.
If the cancer looks like healthy tissue and has different cell groupings, it is called a differentiated or a low-grade tumor. If the cancer looks very different from healthy tissue, it is called a poorly differentiated or a high-grade tumor. The cancer’s grade may help predict how quickly cancer will spread.
Cancer grade is recorded by the pathologist using the letter “G” with a number from 1 to 3 for most cancers and from 1 to 4 in some. In general, the lower the tumor’s grade, the better the prognosis. Different types of cancer have different methods to assign a cancer grade.
Tumor genetics. Researchers have found ways to figure out the genes involved in many types of cancer. These genes may help predict if a cancer will spread or what treatments will work best. This information may help doctors target treatment to each person’s cancer. Learn more about personalized and targeted therapies.
Why Is Cancer Staging Needed
For most types of cancer, doctors need to know how much cancer there is and where it is to help determine the best treatment options. For example, the best treatment for an early-stage cancer may be surgery or radiation, while a more advanced-stage cancer may need treatments that reach all parts of the body, such as chemotherapy, targeted drug therapy, or immunotherapy.
Of course, the stage of a cancer isnt the only factor used to decide which treatments might be best. Sometimes, cancers with different stages might be treated the same way, or cancers with the same stage might be treated in different ways. Many factors determine the best treatment options for each person.
A cancers stage can also be used to help predict the course it will likely take, as well as how likely it is that treatment will be successful. Although each persons situation is different, cancers of the same type and stage tend to have similar outlooks.
The cancer stage is also a way for doctors to describe the extent of the cancer when they talk with each other about a persons cancer.
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 arent staged the way cancers that form tumors are.
Also Check: What Helps With Swollen Feet After Chemo
Stage 2 Ovarian Cancer
Stage 2 ovarian cancer means the cancer is found in one or both ovaries and has spread into other areas of the pelvis. Stage 2 is a small group, compromising 19% of ovarian cancer diagnoses.
- Stage 2A: Cancer has spread to the uterus and/or fallopian tubes .
- Stage 2B: Cancer has spread to other tissue within the pelvis.
- Stage 2C: Cancer is found inside one or both ovaries and has spread to the uterus and/or fallopian tubes, or to other tissue within the pelvis. Also, one of the following is true:
- cancer is found on the outside surface of one or both ovaries or
- the capsule of the ovary has ruptured or
- cancer cells are found in the fluid of the peritoneal cavity or in washings of the peritoneum .
Exams And Tests To Stage Cancer
Different types of exams and tests can be used to figure out a cancers stage.
- Depending on where the cancer is located, a physical exam may give some idea as to how much cancer there is.
- Imaging tests like x-rays, CT scans, MRIs, ultrasound, and PET scans may also give information about how much and where cancer is in the body.
- Endoscopy exams are sometimes used to look for cancer. For these exams, an endoscope, which is a thin, lighted tube is put inside the body to look for cancer.
- A biopsy often is needed to confirm a cancer diagnosis. Biopsies might also be needed to find out if a lump felt on an exam or if something seen on an imaging test in another part of the body is really from the spread of cancer. During a biopsy, the doctor removes a tumor or pieces of a tumor to be looked at in the lab. Some biopsies are done during surgery. But biopsies can also be done using a thin, hollow needle or through an endoscope. For more on biopsies, see Testing Biopsy and Cytology Specimens for Cancer.
- Lab tests of cancer cells and blood tests can also be used to help stage some types of cancer.
Recommended Reading: Back Pain That Radiates To Ribs
How Can I Manage Side Effects Of Cancer Treatment
If youre undergoing cancer treatment, talking with your healthcare provider can help you manage your side effects. Many people find that maintaining a healthy diet helps them feel better and stay stronger. You may also benefit from incorporating exercise into your daily routine. Be sure to clear any dietary changes and activities with your healthcare provider first.
What Is A Cancer Stage
While a grade describes the appearance of cancer cells and tissue, a cancers stage explains how large the primary tumor is and how far the cancer has spread in the patients body.
There are several different staging systems. Many of these have been created for specific kinds of cancers. Others can be used to describe several types of cancer.
Don’t Miss: What Is Papillary Thyroid Cancer