42^nd World Cancer Conference

Cancer: Staging

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Staging describes the severity of a person’s cancer based on the size and/or extent (reach) of the original (primary) tumour and whether or not cancer has spread in the body. Staging is based on knowledge of the way cancer progresses. Cancer cells grow and divide without control or order, and they do not die when they should. As a result, they often form a mass of tissue called a tumour. As a tumour grows, it can invade nearby tissues and organs. Cancer staging can be divided into a clinical stage and a pathologic stage. In the TNM (Tumour, Node, Metastasis) system, clinical stage and pathologic stage are denoted by a small "c" or "p" before the stage (e.g., cT3N1M0 or pT2N0). Pathologic staging, where a pathologist examines sections of tissue, can be particularly problematic for two specific reasons: visual discretion and random sampling of tissue. "Visual discretion" means being able to identify single cancerous cells intermixed with healthy cells on a slide. Doctors may reassess a person’s cancer after their treatment has been completed to determine how the cancer responded to treatment. Such a reassessment, or restaging, may also be done when a cancer has recurred and may require more treatment. This reassessment involves the same tests that were done when the cancer was first diagnosed. After these tests, the doctor may assign a new stage to the cancer. The new stage will be preceded by an “r” to indicate that it reflects the restaging