or, trying to answer the question "What stage am I at, doc?"
When I meet with the patient, a common question is "what stage is my cancer?" Before telling a patient about the stage of their cancer, it is often helpful to describe what “staging” means.
In the world of cancer treatment, staging refers to a process of determining the extent of of a cancer as well as features that may affect prognosis, by using a semi-arbitrary set of rules. We use the word "staging" to describe the process of obtaining laboratory and x-ray data to determine the stage of a cancer. Some patients will need a PET scan, CT scans, and MRI while others may only require a physical examination and blood work.
I often will tell patients that this stage of the cancer is actually a highly technical concept that by itself is not very meaningful and needs to be put into perspective. Different cancers have different rules for how they are staged as well as what the meaning of that stage is in an individual patient.
Generally speaking, a stage I or II cancer typically describes localized (or small) cancers that can be treated with surgery and a stage IV cancer typically describes an advanced cancer that has spread to multiple places in the body, where a stage III cancer usually describes a "locally advanced" cancer; one the has not necessarily spread to distant parts of the body but is a large cancer involving nearby lymph nodes in many cases. Occasionally, the term "stage 0" cancer is used. This does not technically describe a true invasive cancer, but typically a precancerous lesion that can evolve into a cancer if left untreated.
Because every cancer has its own unique rules for staging and prognosis based on stage, the stage of a cancer always needs to be fully explained to the patient in order to put it in perspective; for example, although a stage IV pancreas carcinoma describes a cancer that is unfortunately incurable due to spread to several sites outside of the pancreas, a stage IV diffuse large B-cell lymphoma will be cured in the majority of patients.
In addition to our personal consultation where we explain what the stage of a patient's cancer means in terms of that individual's care, I often will refer patients to printed or online materials so they can get reliable information that directly applies to their case. I have found at the National Cancer Institute, ASCO, and especially the National Comprehensive Cancer Network (NCCN) have very good online references that explain stage of cancer for each type of carcinoma (http://www.stlouiscancercare.com/cancer-resources-on-the-web.html has a list of website links for this purpose).
I always caution my patients to be very careful to get reliable information that applies directly to their case. As the staging systems for each cancer applies only to that cancer, it can be easy to be misled by inaccurate information if the patient is looking up the wrong type of tumor on the Internet.