Cancer staging

When staging or " staging " (English ) is called in oncology that part of the diagnosis, is used to determine the spread of a malignant degree Tumores. It becomes the basis for the decision to which treatment the patient is advised.

Methods

For the staging of cancer all the possibilities of diagnostics are used. Already a physical examination with simple tools provides the first evidence, for example, the involvement of superficial lymph nodes. Are particularly important when Staging the imaging process. Often, biopsy specimens from the primary tumor, metastases from or suspicious lymph nodes are removed. In some situations, the tumor spread can only be clarified with a diagnostic ( exploratory ) surgery. If tissue obtained, one can additionally from the histology and cytology on the biological characteristics of the tumor close (grading; reported in pathological findings as G1, G2, G3, G4 possibly ).

Classifications

Various systems have been developed for the staging. Solid tumors are usually classified according to the TNM system. Where T stands for tumor ( its local spread ), N for node ( lymph node involvement ) and M for metastases ( secondary tumors outside the primarily affected organ ).

Other well-known and used in the cancer registries classifications include:

• Ann Arbor classification ( lymphoma)
• Staging according to Rai and Binet (chronic lymphocytic leukemia)
• CML phases (chronic myeloid leukemia)
• Staging according to Durie and Salmon ( multiple myeloma)
• FAB classification (classification of the French-American - British Cooperative Group ) (acute myeloid leukemia)
• Gleason score ( prostate cancer)

Stage as a basis

For the treatment of cancers of different therapeutic approaches are available. Most treatments are highly effective, but also burdened with significant side effects and dangers. The staging helps to make the best choice in a given situation. In stages I and II, this is often a surgical procedure with resection of the tumor or removal of the affected organ, occasionally supplemented by local radiotherapy. Upon further propagation surgery benefits often little. Instead, may be more promising systemic therapy ( radiotherapy or chemotherapy ).

If it is established due to the staging that a cancer can not be curatively treated ( with healing prospect ), the oncologist is going on restrained and offers a palliative therapy, ie one that has the better quality of life instead of prolonging life to the goal.

The existing staging systems do not claim to fully describe the spread of a disease. Rather, they provide a rough classification, an assessment of prognosis and a systematic record of the progress of a disease and the success or failure of therapy. The latter aspect is particularly important when it comes to gain experience in different treatment centers ( cancer registry ) and make it usable for an individual patient.