Tumor Grading and Staging for Cancer

Introduction

• Lecture by Sarah from RegisterednessRN.com.
• Focus on understanding the grading and staging of tumors in cancer.
• Reminder: Access the free quiz after watching the video.

Tumor Grading

• Definition: Assessing tumor cells under a microscope.
• Process:
  • Tumor portion removed by a doctor.
  • Pathologist examines the cells for size, shape, color, and arrangement.
• Grading Terms:
  • Well Differentiated:
    • Cells closely resemble normal cells.
    • Considered low grade; grow and spread slowly.
  • Poorly Differentiated:
    • Cells appear very abnormal.
    • Considered high grade; grow and spread quickly.
• Grading Systems:
  • Different cancers use different systems (e.g., Nottingham score for breast cancer).
  • Numerical System: Grades 1-4.
    • Grade 1: Well differentiated (low grade).
    • Grade 2: Moderately differentiated (intermediate grade).
    • Grade 3: Poorly differentiated (high grade).
    • Grade 4: Undifferentiated (high grade).

Tumor Staging

• Definition: Describes the main tumor’s location, size, and spread.
• Determination Methods:
  • Imaging (MRI, CT scan, X-ray, ultrasound).
  • Lab results and physical findings.
• Importance:
  • Guides treatment planning.
  • Determines clinical trial eligibility.
  • Assesses cancer aggression and treatability.
• Stage Permanency:
  • Original stage remains constant.
  • Additional information supplements original as cancer progresses.
  • Restaging does not replace original stage, but adds to it.

Staging Classification Systems

• TNM Staging System:
  • Used for solid tumors (e.g., colon cancer).
  • Not used for blood or brain cancers.

TNM Categories

• T (Tumor):

  • Describes primary tumor location and growth.
  • TX: Tumor can’t be measured.
  • T0: No tumor found.
  • TiS: Tumor in situ (original place, non-cancerous yet).
  • T1-T4: Indicates size and growth into other areas (T1 is smaller than T4).
  • Specific letters may describe additional growth detail (e.g., breast cancer).

• N (Nodal Involvement):

  • Describes cancer spread to nearby lymph nodes.
  • NX: Cancer in nodes can’t be measured.
  • N0: No cancer in nodes.
  • N1-N3: Number/location of affected nodes (N3 indicates more than N1).
  • Letters can specify further (e.g., N2a or N2b).

• M (Metastasis):

  • Indicates spread to other body parts.
  • M0: No metastasis found.
  • M1: Cancer has metastasized.
  • Letters can describe further details.

Additional TNM Details

• Lowercase c: Clinical staging (based on pre-treatment tests).
• Lowercase p: Pathological staging (post-surgery).
• Lowercase y: Post-therapy staging.
• Lowercase r: Recurrence.

Numerical Staging System

• Stage 0: Cancer in situ, not invasive.
• Stage 1: Localized cancer, no spread.
• Stage 2: Cancer spread to nearby tissues and nodes.
• Stage 3: Deeper tissue and further node involvement, not distant.
• Stage 4: Metastatic cancer, spread to distant parts.

Conclusion

• This review covered tumor grading and staging.
• Remember to take the quiz linked in the video description.