What Are the Stages of Cancer?
by Sarah Carpenter
There are few people whose lives haven’t been touched by cancer in some way — either directly or indirectly. It is the second leading cause of death in the world after heart disease, and it’s caused when cells divide uncontrollably and spread into surrounding tissues destroying them. Each type of cancer can have various stages, characteristics, severity, treatment options and timelines. Here, we will examine the following:
- What Are the Stages of Cancer and Their Characteristics?
- Considerations in Each Cancer Stage
- Treatment Options and Timelines
- Does All Cancer Start at Stage One?
- Prevention and Early Detection Are Key
What Are the Stages of Cancer and Their Characteristics?
Doctors use a process called staging to find out how much cancer is in a person’s body and where it is located. Staging is necessary because it can help predict where cancer will go next, what types of treatment can stop or slow down the spread and forecast your prognosis. Not all cancers are staged, though. For example, leukemia is a cancer of the blood cells that have already spread throughout the body when it’s found.
To determine the stage of cancer, different types of exams and tests are used. These may include:
- Physical exams which may give some idea as to how much cancer there is depending on where the cancer is located.
- Imaging tests like x-rays, CT scans, MRIs, ultrasound and PET scans. These may also give information about how much and where cancer is in the body.
- Endoscopy exams which are sometimes used to look for cancer. For these exams, an endoscope — a thin, lighted tube (usually with a small video camera on the end) — is put inside the body to look for cancer.
- A biopsy is often needed to confirm a cancer diagnosis. Biopsies are also performed to find out if a lump felt during an exam or seen on an imaging test is cancerous. During a biopsy, the doctor removes a tumor or pieces of a tumor to be looked at in the lab. Some biopsies are done during surgery. However, biopsies can also be done using a thin, hollow needle or an endoscope.
- Lab tests of cancer cells (from a biopsy or surgery) and blood tests can also be used to determine the stage of cancer.
The specific stage of cancer is determined by a few factors including the size and location of the tumor. Most cancers have four stages. However, there are five broad groups. Stages I through IV are the most common, but Stage 0 is the earliest phase which describes cancer still localized to the area where it started. Cancers still in Stage 0 are usually easily treatable and are considered precancerous by most healthcare providers.
- Stage 0: There are abnormal cells in the body with cancer characteristics. This stage of cancer can often be cured.
- Stage I: Cancer is localized to one area and hasn’t spread.
- Stage II: Cancer has grown, but it hasn’t spread to other parts of the body.
- Stage III: Cancer has grown and may have spread to lymph nodes or other tissues.
- Stage IV: Cancer has spread from where it started to other organs in the body — called metastatic or advanced cancer.
Does All Cancer Start at Stage Zero or One?
All cancer does not start at Stage 0 or Stage I, even if newly diagnosed. The stage of cancer depends on its size and location in the body and if it has spread to other organs and tissues. A doctor will use information from test results (clinical stage) or the tumor (pathologic stage) to decide the stage of cancer.
Considerations in Each Cancer Stage
Cancer stages are based on a highly detailed system that includes specific information about the tumor and how it affects the rest of the body. It’s important to understand the cancer stage for several reasons:
- Treatment: It helps the doctor decide which treatment will work best. Early-stage cancer may call for surgery, while advanced-stage cancer may need chemotherapy.
- Prognosis: Recovery will partly depend on how early the cancer is found. Knowing the stage gives an idea of possible outcomes.
- Research: Most hospitals work with a national database that keeps track of which treatments are used and how well they work. Researchers can compare similar cases to find the most effective treatments.
Treatment Options, Outlooks and Timelines
For most types of cancer, doctors need to know how much cancer there is and where it is (among other things) to help determine the best treatment options. The cancer stage isn’t the only factor in deciding which treatments might be best. Sometimes, cancers with different stages might be treated the same way, or cancers with the same stage might be treated differently.
Generally, the early stages of cancer are reserved for stages 0, I and II. Effective treatment for early-stage cancer may be surgery or radiation because the cancer is localized and hasn’t spread. Doctors may also prescribe systemic drug therapy for early-stage cancer. Systemic drug therapy includes medicine that reaches all parts of the body such as chemotherapy, targeted drug therapy or immunotherapy.
The timeline for cancer treatment depends on the treatment plan and the drug or combination of drugs prescribed. If chemotherapy is received, one course of chemo treatment may last between three to six months. Typically, one course consists of several on-and-off cycles with one cycle usually lasting two to six weeks. Targeted therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide and spread. How often and how long targeted therapy is received depends on the
type of cancer, how advanced it is, the type of targeted therapy and how the body reacts to treatment. Immunotherapy enables the immune system to recognize and target cancer cells, making it a universal treatment answer to cancer. Immunotherapy comes as an infusion that you get into a vein over about 30 minutes.
Advanced cancer is reserved for Stages III and IV. In Stage III, cancer has grown and may have spread to lymph nodes or other tissues which can be serious and incurable. In Stage IV, cancer has metastasized and spread from where it started to other organs of the body. Cancer cells may have traveled to the brain, bones, liver and adrenal glands where they may form new metastatic tumors. Treatment for advanced cancer can include the same treatments used for early-stage cancer such as surgery, chemotherapy, targeted therapy, immunotherapy and radiation therapy.
In addition, people diagnosed with both early-stage and advanced cancer may also receive palliative care alongside other treatments. Palliative care eases the symptoms of disease regardless of whether it can be cured and focuses on the well-being of the person rather than the disease. Palliative care includes medication, nutritional changes, relaxation techniques, emotional and spiritual support and hospice. If offered as hospice, palliative care would last six months or less. If the cancer isn’t terminal, palliative care can be offered at any stage, alongside other treatments.
Prevention and Early Detection Are Key
Approximately 40% of men and women in the United States will be diagnosed with cancer at some point in their lives. Dramatic developments in our understanding of cancer development and progression in recent decades have led to improvements in screening and treatment. In turn, greater numbers of survivors live longer after diagnosis, and it is estimated that one-third to one-half of cancers could be prevented by healthier lifestyle choices.
Some practical steps you can take to prevent cancer include:
- Don’t use tobacco products
- Eat a healthy diet
- Maintain a healthy weight and be physically active
- Protect yourself from the sun
- Get vaccinated (certain viral infections can lead to cancer)
- Avoid risky behaviors (your risk of cancer can decrease by practicing safe sex and not sharing needles)
- Get regular medical care (regular self-exams and screenings can increase your chances of discovering cancer early when treatment is most likely to be successful)
Early diagnosis is key and focuses on detecting symptomatic patients as early as possible, giving them the best chance for successful treatment. When cancer care is delayed or inaccessible, there is a lower chance of survival, greater problems associated with treatment and higher costs of care. Early diagnosis improves treatment outcomes by providing care at the earliest possible stage and is an important public health strategy in all settings.
Cancer Screening and Treatment at Yosemite Pathology
Cancer is a complex and destructive disease. There are many types of cancer and various stages, characteristics, severity, treatment options and timelines for each. Knowing the name and stage of cancer will help you find out more about it and help your doctor decide which treatment choices you have.
Since 1948, our laboratory has provided superior and comprehensive diagnostics in anatomic pathology in the Western United States. The broad range of specialties practiced by our dedicated pathologists in the cancer field includes those of the breast, skin, thyroid and gastrointestinal system, among others. For more information about our services, contact us today.
Sarah Carpenter is a freelance writer whose portfolio spans the industries of healthcare, higher education and entertainment. Find out more at her website.