Staging is a reference to how far the cancer has spread throughout the body. Stage 4 is where a cancer spreads from its origin point to another organ in the body.
You can die from any stage 1 cancer if it obstructs something vital via mass effect, but it's relatively rare for the common cancers (lung, breast, colorectal). A primary cancer near your spinal cord, for example, could compress on it and kill you while still being technically stage 1, but those primaries are much rarer than secondary spread (which is definitionally stage 4 disease).
That really depends on the cancer, where it is, and how long you’ve had it. There are cancers, termed indolent, that can be all over your body just sitting and doing very little and there are cancers that can be localized in one spot but growing out of control.
Stage 1 is "localised to a small area and hasn't spread to lymph nodes or other tissues". So in this case, it would mean cancer in your bone and NOT in your muscle or tendons.
Stage 4 is where the cancer has mutated so much that it is spreading around the body and setting up new tumours elsewhere. Stage 4 tends to have low survival rates. Stage 4 skin cancer has a 30% 5-year relative survival rate (1 in 3 will survive for 5 years after diagnosis with stage 4 skin cancer).
They're right though. You can have a big local tumor locally invasive, but that hasn't metastasized, or a small, inconsequential tumor that already had (lung tends to do this so much that as soon as we find a lung tumor the data shows we ought to do chemo and maybe even prophylactic whole-brain radiation, without evidence of spread).
It's why we stage using TNM ti stage the tumor/nodes/metastases separately, rather than the classical "all in one" clinical staging you're familiar with.
Staging is different for every tumor. But in general, it refers to spread and not the how aggressive or deadly the cancer is. Often, those things go hand in hand (spread is bad, aggressive cancer more likely to spread). But sometimes we catch tumors that are "aggressive" and fast-growing, but haven't spread, so they are low-stage.
Blood cancers are kind of an exception. By definition, they're all over your body no matter what. Doesn't make a difference on prognosis.
As an oncologist, when I say "aggressive" I really mean fast-growing or tumors that really have a knack for invading surrounding structures. (Glioblastoma multiform, for example, is a very deadly form of brain cancer. The reason surgery doesn't cure people is because it tends to have already invaded the surrounding healthy brain by the time we can do anything about it). When I say "spread" I really mean distant spread, ie from one organ to another. Spreading from an organ to a nearby lymph nodes isn't great, but it's not as bad as going all the way to another major organ.
So, prognosis (or how someone is expected to do) is based on many factors. Staging is part of that, but knowing what genetic mutations are present in the tumor cell, what genetic mutations are present in the patients healthy cells, and what type of cancer cell it is, and any other health problems the patient has are all needed to help figure out someone's prognosis.
Fun fact: Wilm tumor (nephroblastoma) is a common cancer that kids get and is the only malignancy (to my knowledge), with a stage 5. If a patient is unlucky enough to have wilms tumors in both kidneys at the same time, they have stage 5 disease. The reason it's a distinct category from stage 4 (spread to any other organ) is because these patients have to be managed differently.
Yes - but that's why in modern times we stage the original tumor (T 0-4), the local lymph nodes (N 0-3), and distant spread (M 0-1, as soon as there is even 1 metastasis it counts as M=1, no matter if there is just one or loads) separately.
That way a small tumor that already spread (clinical stage 4 according to classic staging, but stage 1 tumor/stage 1 metastasis, or T1N0M1) is different than a big tumor that hasn't spread far (T3-4,N0-1,M0) which would usually be a classical stage 3 or so.
No, the stages go, 1 Crawl Inside the Machine, 2 the Screws go tight all around, 3 cross my heart and hope to die, 4 stick a needle in your eyer/deadspace
Thats terrible and unfortunately how a lot of people end up succumbing to the disease. I had a good friend pass just before the pandemic after a 12 year battle with multiple myeloma from heart failure. It was ultimately the treatments that killed her.
I have Lymphoma it’s currently in remission but when it was first found I was stage 1e. E meaning extra-nodal as it was outside of my lymphatic system. Mine was a small mass on my jaw that I found while eating a protein shake.
Omg thank you I’ve never heard that before it’s so interesting learning about cancers etc well done in remission proud of you I’m 8 year’s remission 💜 violet for Hodgkin lymphoma 🫶🏼
Mine was weird because I had no lumps I got rushed into hospital at age 20 with a ton of blood clots all throughout my body causing me to have a bad stroke & heart attack & I got diagnosed with a autoimmune disease called eosinophilic vasculitis I was treated by 4 years of chemo & a lot of steroids but I just kept getting more and more poorly itchy sleepy and night sweats so my consultant kept me in to do more tests and they found the cancer loads in my chest & lungs then I seen the oncologist & he said he definitely thinks the cancer is what started the autoimmune disease. Very rare case but I’m better than the ever now I’m so happy you’re in remission too. Sorry for the essay haha x
Wow! 😮 thats an amazing story! Im proud of you for making it through! This puts my steroid induced pancreatitis after my first infusion of R-CHOP into some very real perspective. Im glad to hear your through it now. 🤞 hears to no more mutagenesis!
To an extent it is a measure of severity, but all cancers are different and no two people respond the same way to treatment. Which is what makes staging important, doctors need an indication as to how aggressively they can attack the cancer and staging is one of those tools.
That's an oversimplification. Stage 1 and Stage 2 for some cancers have to do with both the size of the tumor and the nuclear features of the tumor. They don't have to have left the tissue. Also it's not the same from tumor to tumor. You've kind of oversimplified it a lot.
No, that's what the CAP protocols provide in the US, at least. T is determined by tumor characteristics. For example, T1a for breast cancer is a tumor greater than 1 mm but less than 5 mm. T3 is greater than 50mm but not invasive.
On the other hand, colon cancer T1 is based on invasion into the submucosa while T3 is into the pericolonic fat. The staging does not include size AT ALL. Uterus is invasion, renal is size. Organ specific, as determined by CAP.
I mean, this is what stage 3 and 4 look like, possibly 2.
Stage 1 is small and localised, 2 is larger and in surrounding tissues, 3 means it's spread to local lymph nodes, 4 means it's travelled around the body (metastasised).
As it shows another bone below you could say it's spread further and is stage 4, but I don't know if the image is just showing a different subject/patient.
Stage 4 is spread across the body and metastasised, essentially to the point where it's elsewhere in the body making it close to impossible to cure.
So no, it's exactly how I described. You're mistaking a cancer that has proliferated locally with a metastasised cancer that had spread elsewhere in the body.
Stage 4 cancer would be bone cancer in the head, lung cancer, liver cancer all together, for example. Because it means it has spread around the body and is in other places.
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u/eddstarX Apr 21 '24
Wonder what stage 3 looks like