Treatment for Every Stage of Disease
Once diagnosed with cancer, staging determines the extent and spread of the disease in the body and guides the treatment team in recommending the most effective treatments. Depending on the type of cancer, the following factors are used to determine stage of disease:
- Tumor location and relationship to nearby body structures
- Tumor size and number of tumors
- The spread of cancer to the lymph nodes
- Metastasis, or the spread of cancer to other parts of the body.
What Staging Means
Staging for most non-hematologic cancers is based on a rating system called the TNM system - short for Tumor, Nodes, and Metastasis. The TNM system assigns a number to each factor describing the size, location, and spread of cancer.
When each factor from the TNM system is combined, a disease
stage can be determined. These are the numbered stages you or a loved one may hear, or be already be familiar with, during discussions of your diagnosis.
The criteria for tumor stage is different for each type of cancer. For example, patients with the same TMN numbers for lung and bladder cancer may have a different stage of disease.
Below are short general descriptions of the TNM disease stages:
Cancer in situ. This early cancer is only present in the layer of cells in which it began.
Local cancer. This cancer remains in the local tissue and has not spread to nearby lymph nodes.
Locally advanced cancer. This type of cancer may involve surrounding tissue and lymph nodes.
Further locally advanced cancer. Depending on the type of cancer, this stage usually means the tumor has spread to surrounding tissue and lymph nodes.
Cancer with distant metastasis. The cancer has spread to another organ distant from where the tumor originally started.
While most solid tumors or lesions are described in this manner, not all cancers are staged using the TNM System. These cancers include brain and spinal cord cancers, along with most cancers of the blood and bone marrow. Lymphoma and leukemia are examples of cancers not staged using the TNM system.
For more information about tumor staging, visit the National Cancer Institute website at
The following information is typically used by the physician to determine disease stage:
A physical exam by your health care provider might provide that first indication that a tumor has developed, as well as possible spread of cancer to the lymph nodes.
Xrays, CT scans, MRI, ultrasound and PET scan are some of the imaging studies that give information about tumor size and location in the body.
Pathology and Laboratory Tests
Pathologists at Torrance Memorial perform numerous tests on samples of blood, tissues and other body fluids to aid in the staging of a patient's cancer. These exams typically indicate the specific type of cancer cell and how aggressively it may be growing.
Staging can also be determined by evidence of cancer found during surgery to remove a tumor. These reports provide information on the size and location of a tumor and the spread to nearby lymph nodes or organs.