After the determination is made as to the type of cancer, the cancer is graded--a measurement of how aggressive the tumor is. Most cancer cells are graded by how much they look like normal cells. Grading is done in the lab using cancer cells taken during biopsy.
Cancers are usually graded from low to high. Low-grade cancers look more like normal tissue under the microscope. High-grade tumors look very abnormal and are generally more aggressive with a poor outcome.
Once cancer is diagnosed, more tests will be done to find out the size of the tumor and whether the cancer cells have spread to other parts of the body. This testing is called staging. To plan treatment, a doctor needs to know the stage of the disease. Stage refers to the extent, or the size, of the cancer and whether it has spread from where it started. Each cancer, by organ, has its own staging system. In most cases, stage is labeled with zero and Roman numerals I through IV, with stage IV being the highest stage.
Higher numbers usually mean more extensive disease, larger tumor size, and/or spread of the cancer beyond the organ in which it first developed to nearby lymph nodes and/or nearby organs. Once a stage is assigned and treatment given, the stage is never changed. For example, if a stage I cancer of the cervix is treated, and two years later a metastasis (spread of the same cancer) is found in the lung, it is not now stage IV, but remains a stage I, with recurrence to the lung. However, some cancers may be restaged.
The important thing about staging is that it determines the appropriate treatment, helps doctors provide a prognosis, and allows for comparison of treatment results between different treatments.
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