STAGE 4 CANCER
What Is Stage 4 Cancer?
Not All Stage 4 Cancers Are The Same
In the last blog we spoke about surviving stage 4 cancer. First, we look at what survivorship means… to you. Now, lets take a look at what “Stage 4 Cancer” means in stage 4 breast cancer, stage 4 lung cancer, stage 4 prostate cancer, etc., I know this should go without saying, but this is only applicable, if you do have a cancer diagnosis.
What is Cancer Staging?
The “STAGE” is the sum total of 3 components used to describe cancer and how aggressive it may be behaving. In many cases (not all) Cancer Stage is described by T-N-M. Once a cancer diagnosis is made, your doctors will order lots of tests (blood work, CT scan, PET-CT, biopsies, etc.,) to determine your T-N-M and eventually your overall stage. Why? Because ALL treatment recommendations are based on the stage of the cancer. A Stage I cancer is treated differently from a stage III cancer, which is treated differently from a stage IV cancer. Treatment may be surgery alone, or chemotherapy alone, radiation therapy alone, various combination of these three common treatments, or all 3 may be recommended!
How Is Caner Staging Done?
T-N-M is used to describe most cancer and provide a common language for doctors and researchers to communicate about cancer. Once the T-N-M is known, they can be placed in groups called STAGE. It is like a math problem: T+N+M = Group Stage (I, II, III or IV). First, let’s talk about T-N-M.
- Tumor: Describing the tumor is different based on the organ where the cancer is located (breast, prostate, bladder, lung, etc.,). The 2 most common ways to describe tumor is by the size (such as in breast cancer and lung cancer) or by depth of tumor invasion (such as in colon cancer and esophageal cancer [esophagus = swallowing tube]) The bigger the size or greater the depth of invasion, the more aggressive the cancer is thought to be, and likely higher the Stage
- Node: Cancer wants to take over territories…it wants to go to other organs/parts of the body. The only way to do that is to leave where it is located (point of origin, such as prostate, breast, lung, etc.,) and travel to other parts of the body. The first road, or access points are usually through the blood vessels and the lymphatic system. In the lymphatic system cancer cells are often trapped in the lymph node nets/sieve. Finding cancer cells in lymph nodes will also place you in a higher cancer stage
- Metastases: this is (usually) simply define as cancer escaping and traveling to a different part of the body and growing there as well. Examples includes: Breast cancer spreading to the bones, or brain. Colon cancer spreading to the liver, or lung. Lung cancer spreading to the brain, etc., Once the cancer has spread this far, it is considered Stage IV cancer. However, in some organs, such as the bladder, a stage 4 cancer can be diagnosed based on the T stage depth of invasion. All Stage IV cancers are NOT created equal.
Take a look at this FREE video course on skin and colon cancer to get a better understanding of staging using the TNM stage.
How Do I Know If I Have Stage 4 Cancer?
Stage IV cancer can only be diagnosed after certain tests are done. Specifically, your oncology team will be looking to see if the cancer spread elsewhere. They may request bone scans, MRI, PET-CT scans, etc., Know that sometimes, stage 4 cancer can be in the same organ, but on a different side, as in lung cancer.
Here are two examples of using the T-N-M stage to get to Stage IV
- Tumor is Invasive Ductal Carcinoma measuring 3.1cm,
- Nodes involved are 3 positive out of 10 removed,
- Metastases MRI showed 2 brain lesions M1
- STAGE: T2N1M1 = Stage IV (4)
- Tumor is Right lung Squamous Cell Carcinoma (Non-Small Cell Lung Cancer – NSCLC) measuring 4.2cm – T2b
- Lymph Nodes positive in the sub-carina – N2
- Metastases – lesions seen in the left lung – M1a
- STAGE: T2bN2M1a – Stage IVa (yes, there is also stage IVb and IVc, with spread to more distant organs
As you can see, there is much to consider when staging cancer. The treatment recommendations will also be different, based on the type of cancer. Many are living with stage 4 cancers for many years. A diagnosis of stage 4 cancer is not always the end of the road. Be an advocate for yourself and ask your cancer team questions. In our next blog, we will continue to peel away at the many layered question of “What is Stage IV Cancer?” Stay tuned.
Until next time know that,
Life is beautiful and God is awesome. And know, you are pure awesomeness!
Ipsa Scientia Potestas est ——— Knowledge itself is power!
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