What Are the Stages of Cancer?

Have you ever wondered what it meant when you heard something like, “so-and-so has stage 3 breast cancer?” The breast cancer part probably makes sense, but what does the stage mean?

When you’re diagnosed with cancer, the doctor will give that cancer a “stage,” a way of describing how advanced the cancer is. The stage helps the doctor guide the best course of treatment.

According to Robert Dreicer, MD:

• Cancer staging is done at initial diagnosis.
• The initial stage does not change even if the disease progresses.

All cancers are given stages. But two different types of cancer – even at the same stage – may differ a lot in life expectancy and chance of recurrence. Symptoms and treatment options can also differ wildly among different types of cancers within the same stage.

There are two main groups of cancers: solid tumor cancers and hematological (blood) cancers. Hematological cancers like leukemia and multiple myeloma have completely different staging criteria than solid tumors. This post will focus on solid tumor cancers.

The Stages of Solid Tumor Cancers

In general, solid tumor cancers have four stages.

Stage 1 Cancer

• Small tumor
• Has not spread to surrounding tissues or lymph nodes
• Treatment: Surgery and/or radiation, usually localized, or at the site of the tumor

Stage 2 Cancer

• Similar to stage 1, but the tumor is larger
• Treatment: Surgery and/or radiation, usually localized

In some types of cancers, stage 2 includes cancer that has spread to nearby lymph nodes.

Stage 3 Cancer

• Considered “locally advanced” and has grown large in its initial location (sometimes referred to as the “organ of origin”)
• Potentially has also spread to nearby lymph nodes
• Treatment: May include surgery, radiation and/or chemotherapy

Stage 4 Cancer

• Has spread (or metastasized) beyond its original local area and nearby lymph nodes to other organs
• Treatment: May include surgery, radiation and/or chemotherapy

How Doctors Determine Stages of Cancer

There’s a difference between clinical staging and pathological staging. Pathological staging, in addition to the results from imaging studies (CT scan, MRI, PET/CT scan) looks at the actual cancer tumor and cells after surgery. Your cancer treatment may not include surgery, in which case pathological staging won’t apply.

Clinical staging does not rely on a tumor’s pathology, but on a physical exam and imaging results. Sometimes the cancer’s clinical stage differs from the pathological stage – for example, during surgery, the surgeon might discover the cancer has spread farther than they previously thought.

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In order to determine the cancer’s stage, doctors may use a combination of:

• Physical exams
• Imaging, such as x-rays, MRIs, CT scans, PET scans or ultrasounds
• Biopsies, which involve collecting tissue samples and examining them under a microscope

How Aggressive is the Cancer?

In addition to stages of cancer, there are also grades of cancer. Doctors look at cancer cells under a microscope to determine the grade, which may provide additional information to predict how quickly the cancer will grow or spread. “In general, higher grades tend to have more aggressive behavior,” Dreicer says.

The more the cancer cells look like normal cells, the lower the grade. More abnormal cancer cells are more likely they are to grow and spread quickly. Doctors use both grades and stages to determine the best treatment option.

In general, the earlier any cancer is caught, the better the chance it can be treated. Talk to your doctor about staying up-to-date with cancer screenings.