When a person is diagnosed with cancer, the first thing doctors need to do is determine the stage of the cancer. The stage tells how far the cancer has spread within the body, whether it is confined to a specific area or has spread to other organs or lymph nodesKnowing the stage is essential as it helps doctors decide on the most appropriate treatment approach and gives information about the patient’s condition. diagnosis of disease,

According to Dr Amit Upadhyay, senior consultant, oncology and hemato-oncology at PSRI Hospital, New Delhi, there are several different cancer staging system, the TNM system is most commonly used. This system divides cancer staging into three major components:

T (tumor): This factor measures the size of the primary tumorWith stages from T0 to T4. A larger tumor corresponds to a higher stage.

n (nodes): Measures whether cancer has spread to nearby lymph nodes. N0 stage means no spread, while N1, N2 and N3 indicate different levels of lymph node involvement.

M (transformation,: M0 means the cancer has not spread to distant organs, while M1 indicates it has metastasized to other areas of the body.

These three factors combined help doctors understand the extent of the disease and make appropriate decisions treatment plan,

Dr. Upadhyay explains that it is important to understand the specific stage to determine treatment. The stages range from 1 to 4, with each stage representing a different level of cancer progression:

first stage: The tumor is still confined to one area and can often be treated with a single method, such as surgery or radiation. In some cases, Chemotherapy Can be used as additional treatment.

Stage 2 and Stage 3: These are considered locally advanced cancers where the tumor has spread to surrounding tissues or lymph nodes. Treatment usually involves a combination of surgery, radiation, chemotherapy, and sometimes immunotherapy.

step 4: This is metastatic cancer, where the tumor has spread to distant organs such as the liver, lungs or bones. Treatment at this stage often involves systemic therapy such as chemotherapy or immunotherapy.

Stages 1 to 3 generally represent cancers that are localized or have spread to nearby areas. These cancers are often treatable and, depending on the stage, can be cured with surgery, radiation and/or chemotherapy. Dr. Upadhyay says staging helps doctors predict the best outcomes for patients, as cancers diagnosed at these stages have a higher chance of successful treatment.

For cancer that has reached stage 4, it has spread to distant organs, making it more difficult to treat. At this point, the focus often shifts from curative treatment to palliative care, aimed at improving quality of life and increasing survival. Dr. Upadhyay explains that although stage 4 diagnosis is more challenging, systemic treatments such as chemotherapy and immunotherapy are often the best options for controlling spread and managing symptoms.

To accurately determine the stage of cancer, Dr. Patil explains that a whole-body PET-CT scan is often performed before treatment. This scan helps doctors understand whether the cancer has spread within the organ or to other parts of the body.

For example, in case of breast cancer:

step 0: Stage 0 breast cancer, also known as ductal carcinoma in situ (DCIS), is a non-invasive breast cancer that occurs when abnormal cells are found in the lining of the breast ducts. It is a pre-invasive cancer, which means that the cancer cells have not spread beyond the breast ducts into the surrounding breast tissue.

“Stage 0 breast cancer, though non-aggressive, is important to identify and monitor as it can progress if left untreated,” says Dr Pratik Patil, consultant, medical oncology at Jupiter Hospital, Pune. “Understanding the presence of DCIS helps determine whether intervention is necessary and may prevent the development of invasive cancer.”

first stage:Cancer is limited to the breast.

Step 2: Cancer has spread to nearby breast tissue or fat.

step 3: Cancer involves the breast, surrounding tissue, and lymph nodes in the armpit (underarm area).

step 4: Cancer has spread to distant organs such as the lungs or liver.

Dr. Patil says that the higher the stage, the more aggressive the treatment should be. For cancer in stage 3 or 4, chemotherapy or injectable therapy is often necessary. However, for early stages, surgery is often the first line of treatment, with chemotherapy used later if necessary.

In addition to informing treatment approaches, understanding the stage helps doctors estimate prognosis. Stage 1 to 3 cancer is generally considered curable, with a low risk of recurrence. In contrast, the prognosis of stage 4 cancer is usually poor, and treatment focuses more on extending life and increasing comfort.

Both D. Upadhyay and Dr. Patil emphasize the importance of performing accurate staging tests such as PET-CT scan before starting treatment. By doing this, doctors can plan the most effective course of action, improving the chances of a successful outcome and, in some cases, even curing the cancer.

Finally, understanding the stage of cancer is important not only to determine the right treatment plan but also to assess the patient’s chances of recovery. Early-stage cancers are more treatable and have better outcomes, while stage 4 cancers require more specialized, palliative care. Staging is an essential part of the cancer journey, guiding both the treatment approach and long-term prognosis.

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