Showing posts with label Staging. Show all posts
Showing posts with label Staging. Show all posts

Lung Cancer - Staging

Staging is the extent of the spread of cancer definition method. Staging is very important, it is because of your recovery and treatment may depend on the profile of your cancer staging. For example, a period of cancer may be the best treatment, while the other would be preferable in the treatment of chemotherapy and radiotherapy. Small-cell and non-small cell lung cancer staging system is not the same.

Patients with lung cancer treatment and prognosis (survival may Overview) depends largely on the stage of cancer and cell types. CT, MRI, scans, bone marrow biopsy, mediastinal microscope and hematology checks can be used for cancer staging.

Be sure to let your doctor you can understand the way in which you explain your view, to decide which treatment best suited to your personal medical situation.

Non-small cell lung cancer staging:
Most often used to describe non-small cell lung cancer (NSCLC) is the growth and spread of the TNM staging system, also called the American Joint Committee on Cancer (AJCC). In the TNM staging, combined with the tumor, nearby lymph nodes and distant organs transfer of information, which used to refer to specific phases of the TNM grouping. Packet staging and the use of digital 0 Roman numerals I to IV to describe.

T representative tumor (in the lungs, as well as the size and extent of the spread of approaching organ), the representative lymph node spread of N, M said metastasis (spread to distant organs).

Non-small cell lung cancer staging T: T classification according to the size of lung cancer in the lungs and the proliferation of location, spread to the extent of approaching organizations.

Tis
- Cancer confined to the airway lining cells pathway. Not spread to the other lung tissue, lung cancer is often called carcinoma in situ.

T1
- Tumors less than 3 cm (slightly less than 11 / 4 inches), did not spread to visceral pleural (lung wrapped with the membrane), and did not affect the main bronchus.

T2
- Cancer one or more of the following characteristics:


  • greater than 3 cm

  • main bronchial involvement, but from the carina (trachea into place around the main bronchus) more than 2 cm (about 3 / 4 inches).

  • Already spread to the visceral pleura

  • Cancer partial obstruction of the airway, but did not cause lung or in proper pneumonia

T3
- Cancer one or more of the following characteristics:



  • Spread to the chest wall, diaphragm (to be separate from the chest and abdominal respiratory muscle), mediastinal pleura (the gap between the lungs wrapped with the membrane), or layer of pericardial (heart wrapped membrane).

  • Side of the main bronchial involvement from the carina (trachea into place around the main bronchus) less than 2 cm (about 3 / 4 inches) but do not include the carina.

  • Into the airway has been long enough to cause lung or all in proper pneumonia.


T4
- Cancer one or more of the following characteristics:



  • Spread to mediastinal (sternum after the gap in front of the heart), heart, trachea, esophagus (connecting hose pipe and the stomach), spine, or carina (trachea into place around the main bronchus).

  • With a lobe, there are two or more independent of tumor nodules

  • With malignant pleural effusion (fluid around the lung, cancer cells contain).

Non-small cell lung cancer classification N
N staging of cancer depends on the violation of the lymph nodes near.
N0: cancer has not spread to lymph nodes
N1: the proliferation of lymph node cancer confined to the lungs, hilar lymph nodes (located in bronchial pulmonary enter the local environs). Limited to the lymph node metastasis from lung ipsilateral.
N2: carina cancer has spread to lymph nodes (around tracheal bronchus into position around), or mediastinal lymph node (sternum after heart before the gap). Limited to the lymph nodes involved with ipsilateral lung.
N3: Cancer has spread to the ipsilateral or contralateral supraclavicular lymph node, and (or) from spreading to the contralateral lung hilar or mediastinal lymph nodes.



Table 1: Non-small cell lung cancer group stages



Non-small cell lung cancer staging M
M phases depends on whether the cancer organization or transferred to distant organs.
M0: no distant proliferation.
M1: cancer has spread to one or more distant sites. Other sites include distant lobe, exceeding by more than N staging, and the lymph nodes or other organs, such as the liver, bone or brain.
Non-small cell lung cancer staging groups: Once the T, N and M phases clear, and the combination of these messages (phased organization) would be a clear integrated phases 0, I, II, III or IV period (see table 1). Staging relatively low patient survival prospects good.



Stage small cell lung cancer
Although small cell lung cancer can be as non-small cell lung cancer the same stage, but doctors found that the vast majority of physicians two more simple system in the treatment of a better option. The system will be divided into small-cell lung cancer, "the deadline" and "extensive" period (also called the proliferation of period).


Deadline that the cancer is limited to the lung and lymph nodes only side in the same side of the chest.


If the cancer spread to the other side of the lung, chest or contralateral lymph nodes or distant organs, or is enveloping the pulmonary malignant pleural effusion, called extensive period.



Breast Cancer - Staging

Breast cancer is staged according to the TNM system, updated in the AJCC Staging Manual, now on its sixth edition. Prognosis is closely linked to results of staging, and staging is also used to allocate patients to treatments both in clinical trials and clinical practice. The information for staging is as follows:

TX: Primary tumor cannot be assessed. T0: No evidence of tumor. Tis: Carcinoma in situ, no invasion T1: Tumor is 2 cm or less T2: Tumor is more than 2 cm but not more than 5 cm T3: Tumor is more than 5 cm T4: Tumor of any size growing into the chest wall or skin, or inflammatory breast cancer

NX: Nearby lymph nodes cannot be assessed N0: Cancer has not spread to regional lymph nodes. N1: Cancer has spread to 1 to 3 axillary or one internal mammary lymph node N2: Cancer has spread to 4 to 9 axillary lymph nodes or multiple internal mammary lymph nodes N3: One of the following applies:

Cancer has spread to 10 or more axillary lymph nodes, or Cancer has spread to the lymph nodes under the clavicle (collar bone), or Cancer has spread to the lymph nodes above the clavicle, or Cancer involves axillary lymph nodes and has enlarged the internal mammary lymph nodes, or Cancer involves 4 or more axillary lymph nodes, and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.

MX: Presence of distant spread (metastasis) cannot be assessed. M0: No distant spread. M1: Spread to distant organs, not including the supraclavicular lymph node, has occurred

Summary of stages:

Stage 0 - Carcinoma in situ
Stage I - Tumor (T) does not involve axillary lymph nodes (N).
Stage IIA – T 2-5 cm, N negative, or T <2 cm and N positive.
Stage IIB – T > 5 cm, N negative, or T 2-5 cm and N positive (< 4 axillary nodes).
Stage IIIA – T > 5 cm, N positive, or T 2-5 cm with 4 or more axillary nodes
Stage IIIB – T has penetrated chest wall or skin, and may have spread to < 10 axillary N
Stage IIIC – T has > 10 axillary N, 1 or more supraclavicular or infraclavicular N, or internal mammary N.
Stage IV – Distant metastasis (M)
Breast lesions are examined for certain markers, notably sex steroid hormone receptors. About two thirds of postmenopausal breast cancers are estrogen receptor positive (ER+) and progesterone receptor positive (PR+).[83] Receptor status modifies the treatment as, for instance, only ER-positive tumors, not ER-negative tumors, are sensitive to hormonal therapy.

The breast cancer is also usually tested for the presence of human epidermal growth factor receptor 2, a protein also known as HER2, neu or erbB2. HER2 is a cell-surface protein involved in cell development. In normal cells, HER2 controls aspects of cell growth and division. When activated in cancer cells, HER2 accelerates tumor formation. About 20-30% of breast cancers overexpress HER2. Those patients may be candidates for the drug trastuzumab, both in the postsurgical setting (so-called "adjuvant" therapy), and in the metastatic setting.