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Dr. Elvis Peter Joseph

Consultant - Surgical Oncology

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Dr. Elvis Peter Joseph

Consultant - Surgical Oncology

Manipal Hospitals, Millers Road

Grade VS Stage In Cancer

Posted On: Jun 06, 2023

blogs read 4 Min Read

Cancer specialist in Millers Road

A cancer diagnosis marks a pivotal moment in the journey of cancer care treatment as it serves as the cornerstone for formulating an effective treatment plan by the top surgical oncologist in Bangalore. Two essential terms that are significant in cancer diagnosis are cancer grade and stage. Although often used interchangeably, both terms are completely different and impact the course of treatment in different ways.

In this article, we will discuss the intricacies of cancer grade and stage, how they differ from each other and highlight whether they correlate in the battle against cancer.

What Is Tumour/Cancer Grade?

The grade of cancer represents a fundamental aspect of diagnosis, offering insights into the cellular characteristics and behaviour of malignant tumours. Unlike the stage, which focuses on the extent and spread of cancer within the body, the grade pertains to the level of abnormality exhibited by cancer cells under a microscope. It serves as a measure to assess its cell structure and identify any suspected irregularities.

The grade of cancer also helps assess the rate at which the cancer cells are growing - the lesser the grade value, the lesser the growth rate. Depending on the amount of abnormality visible under the microscope in a cell structure, the grading of a cancer cell is done. The grading system usually followed has 4 grades:

  • Grade 1- Well Differentiated

Cells with a resemblance to normal cells multiply at a slow rate.

  • Grade 2 - Moderately Differentiated (Intermediate Grade)

Cells have no resemblance to normal cells, and the pace of multiplying is faster than normal cells.

  • Grade 3 - Poorly Differentiated (High Grade)

Cells that have abnormal shapes altogether are multiplying aggressively.

  • Grade 4 - Undifferentiated (High Grade)

The cell has lost its integrity and is cancerous.

What is the Stage of Cancer?

The size of the tumour as a whole and the involvement of adjacent structures at the site where the tumour originated are determined by the stages of cancer. There are different staging systems, but the one most commonly used is TNM staging.

TNM Cancer Staging System

The TNM system is the most commonly followed staging system because of its proper sub-staging and easy implementation. The 3 factors on which TNM staging is determined are as follows:

  • T- The tumour size

  • N- No. of lymph nodes involved

  • M- Metastasis to other parts of the body.

There is no assigned value after each of these factors, for example, T1N0MX or T3N1M0. The letters and numbers represent the extent of the tumour.

  • Primary Tumour (T)

T as mentioned, refers to the tumour size. Depending upon the extent, different types of tumours are termed: T1, T2, T3, and T4.

T1 represents the tumour with minimal size, while T4 represents the tumour with the largest size. There is a specific range of size for all types of tumours that varies according to the type and organ involvement.

  • Regional Lymph Nodes (N)

The letter "N" represents lymph node involvement which can be referred to as N0 to N3, with N0 representing no node involvement. The higher the number N, the greater the involvement of lymph nodes.

  • Distant Metastasis (M):

Distant metastasis determines if the tumour has metastasised to distant parts of the body. Different types of metastasis stages include:

  • MX - Metastasis cannot be determined.

  • M0 - Cancer has not spread to other parts of the body.

  • M1 - Cancer has spread to other parts of the body.

The grading and staging of cancer are two different things. While the grading is more about knowing the microscopic structure of the cell and its aggressive nature, the staging is all about the size of tumours and their spread in the body. A tumour with a higher grade more often tends to spread rapidly through the body, resulting in higher staging if not detected early. However, a tumour that has a low grade will have less tendency to spread in the body, resulting in low staging. One should remember that the sooner the cancer is detected, the better, and with a proper evaluation by an oncologist, cancer can easily be managed with appropriate medical intervention at the top cancer hospital in Millers Road.

FAQs 

  • Is staging and grading the same?

No, staging and grading are two different things. Staging is to categorise the extent of cancer, while grading mentions the type of cancer and how aggressive the abnormal cell is.

  • Do high-grade cancers have high stages as well?

Cancer that is graded higher means it is aggressive and can spread rapidly, which may lead to higher staging. But it also depends on how early the higher-grade cancer was diagnosed. If it is diagnosed early, the stage may be early.

  • How can cancers be diagnosed at an early stage (stage 1)?

Screening for cancers depending on history, lifestyle, and genetic factors is the best way to diagnose cancers early when there is a much higher chance of a cure. This includes a clinical examination by an oncologist and investigations including blood tests and imaging (X-ray, mammogram, CT, or PET scan).

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