Dr. Kenyon Meadows, board-certified radiation oncologist with Southeast Georgia Health System
Cancer Care Centers. Let’s take a couple of minutes to talk about cancer staging.
Staging is the process by which your doctors determine how much cancer
you have in your body and exactly where it is located. It almost always
involves a biopsy, taking a sample of a suspicious area. They may suspect
this area contains cancer cells because of your symptoms. Or, perhaps
a routine screening test, such as a mammogram or PSA blood test or colonoscopy,
indicated the possibility of cancer cells. Once a diagnosis of cancer
is confirmed, specialized radiologic tests can be used to confirm its
stage. Determining its stage has a profound impact on your treatment recommendations
and your anticipated outcome. Let's go through an illustrative example
of one of the most common cases I see, which is lung cancer.
And please keep in mind, this is by no means a comprehensive review, but
rather, I want to highlight a few key areas.
Here we see an example of a relatively small area of lung cancer that is
less than three centimeters in size. There's no evidence of any spread
to the lymph nodes in the middle of the chest or any other organs besides
the lung. This is stage one, and this patient would be offered either
surgery or a very high dose per treatment of radiation, such as that offered with
CyberKnife, over a period of only three to five days. With either approach, this
patient would be expected to have a good outcome.
Here is an example of stage three where the tumor has spread from the lung
to the lymph nodes in the middle of the chest. Most often these patients
are treated with multiple weeks of radiation and chemotherapy at the same
time if they can tolerate it. The cure rate in this situation is much
more modest, averaging approximately 20 percent.
In stage four, we have clear evidence that there has been spread of the
cancer beyond the lung to other organs, such as the liver or bone. In
this scenario, chemotherapy is the usual initial recommendation with the
goal of prolonging the patient's life, although there is no expectation of cure.
Radiation therapy is sometimes added as well with the goal of helping with certain symptoms,
such as to ease pain.
I hope these examples have illustrated the paramount importance of how
arriving at an accurate stage is a crucial step in your overall cancer
care. Luckily, technology has progressed to where we can catch lung cancer
in stage one, when the outcome of being cured is the highest. Stay tuned
for next month’s video blog to learn about life-saving screenings.
If you have follow-up questions, please submit them in the box below. Thanks