WHAT DOES MY FRIEND’S CANCER STAGE # MEAN?

First, let me begin with a statement: A Cancer Fighter’s identity is found in FIGHTER not in a Stage #!

A Cancer Fighter who finds PEACE and JOY in the midst of their fight, might be the most tangible display of HOPE our world could ever see.

One of the many “firsts” a Cancer Fighter encounters is the staging of their cancer. For me, when my doctor called with confirmation on my diagnosis, it was the first time I encountered the descriptor “Stage IV Colorectal Cancer” in my life. And, if you’re like me, you don’t really know what that means, except that it must be worse than Stages 1-3.

So, without going into a full blown explanation of the TNM staging system, we’d like to cover just the basics.

Why is naming the Stage important?

The staging number helps describe where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Knowing a stage number helps your cancer team with:

• Planning the treatment. Which could include surgery and whether chemotherapy or radiation therapy are needed.

• Predicting the potential that the cancer could come back after the original treatment.

• Predicting the probability percentage for recovery

• Talking about the diagnosis with clear and common terminology with the entire healthcare team.

• Determining how well the treatment(s) worked.

• Comparing how well new treatments work among large groups of people with the same stage and type diagnosis.

I’ve never heard of the TNM staging system, what is that? Please don’t lose me in jargon!

It’s okay if you haven’t heard of the TNM staging system, so don’t sweat it. While we’re not going into technical detail here, we want to cover many of the basics. The TNM staging system was created by the American Joint Committee on Cancer (AJCC) to describe a cancer’s stage for the purposes mentioned briefly above. The system asks doctors to answer the following questions based on results from scans, testing, imaging, and surgery:

• How large is the primary tumor? Where is it located? (T for Tumor)

• Has the tumor spread to the lymph nodes? If so, where and how many? (N for Node)

• Has the cancer spread to other parts of the body? If so, where and how much? (M for Metastasis)

• Are there any biomarkers or tumor markers linked to the cancer that may make it more or less likely to spread?

You may or may not hear your cancer team use the words “clinical” or “pathological” - but if you do, here’s an easy way to know what they mean:

• Clinical staging is based on the results of test done before surgery, such as physical examinations and scans.

• Pathological staging is based on what is found during surgery.

Okay, but what about those stage numbers? What do those mean? My good friend was just diagnosed with Stage __ Colorectal Cancer, what do the stage numbers mean?

Great question. In the simplest of explanations, your cancer team combines the TNM data and other elements specific to the cancer to determine the stage of cancer for each person. Most cancer types have 4 stages: I (1) to IV (4). Some cancers have a 0 (zero). So, here’s a brief and easy cheat sheet:

• Stage 0. Stage 0 cancers are still located in the place they started and have NOT spread to nearby body tissues. This stage of cancer is often highly curable, usually by surgery to remove the entire tumor.

• Stage I. This stage is often a tumor that has not grown deeply into nearby tissues. It also has not spread to the lymph nodes or other parts of the body. This is an early-stage cancer.

• Stage II and Stage III. These two stages indicate larger cancer tumors that have grown into nearby tissue. They may have spread to lymph nodes, but not to other parts of the body.

• Stage IV. This stage means that the cancer has spread to other organs or parts of the body. This is advanced cancer.

BOTTOM LINE: This is by no means a comprehensive explanation of the staging system. But, this is a very basic explanation, so that you can better understand what this means for you, your spouse, friend, or loved one. The lower the Stage # the higher probability of survivorship and length of life, BUT with no guarantees of that.

PLEASE NOTE: Everyone’s cancer journey is different and affected by a myriad of outside factors (age, genetics, reaction to therapy, etc.). So, even a Stage IV diagnosis is by no means a death sentence. Cancer Fighters have beat the living crap out of Stage IV cancers, and you or your loved one can too! A Cancer Fighter’s identity is found in FIGHTER not in a Stage #!

You are NOT your Stage #! You are a living, breathing, beacon of HOPE! You are NEVER alone in this FIGHT!