Tumor Grading and Staging for Cancer

Introduction

• Speaker: Sarah from RegisteredNurseRN.com
• Topic: Tumor grading and staging in cancer
• Resource: Free quiz available after the video for self-assessment

Tumor Grading

• Purpose: Assesses tumor cells microscopically to determine similarity to normal cells.
• Process:
  • Tumor cells are extracted and analyzed under a microscope by a pathologist.
  • Pathologist examines cell size, shape, color, and arrangement.

Grading Terms

• Well Differentiated:
  • Cells appear similar to normal cells.
  • Considered low grade; grow and spread slowly.
• Poorly Differentiated:
  • Very abnormal cells.
  • Considered high grade; grow and spread quickly.

Grading Systems

• Numerical Rating:
  • Varies by cancer type (e.g., Nottingham score for breast cancer).
  • Common scale: Grades 1 through 3 or 4.
  • Grade 1: Well differentiated, low grade.
  • Grade 2: Moderately differentiated, intermediate grade.
  • Grade 3: Poorly differentiated, high grade.
  • Grade 4: Undifferentiated, high grade, extremely abnormal.

Tumor Staging

• Purpose: Determines tumor location, size, and spread.
• Process:
  • Uses results from imaging (MRI, CT, X-ray), lab tests, and physical examination.

Importance of Staging

• Guides treatment planning.
• Determines eligibility for clinical trials.
• Assesses cancer aggressiveness and treatability.

Staging Characteristics

• Fixed at Diagnosis: Does not change even if cancer progresses or is restaged.
• Types of Staging:
  • Clinical Staging: Before treatment, based on tests.
  • Pathological Staging: After surgery, provides detailed extent.
  • Post-Therapy Staging: After treatments like radiation.

TNM Staging System

• Used for: Solid tumors (e.g., colon cancer).
• Not Used for: Blood cancers (e.g., leukemia) or brain/spinal cord tumors.

TNM Components

• T (Tumor): Describes primary tumor's location and growth.
  • Tx: Tumor can't be measured.
  • T0: No tumor found.
  • Tis: Tumor in situ (original position, not spread).
  • T1-T4: Size/extent of tumor growth (higher number = more growth).
• N (Nodes): Spread to regional lymph nodes.
  • Nx: Cannot measure lymph node cancer.
  • N0: No lymph node cancer.
  • N1-N3: Amount/location of lymph node involvement.
• M (Metastasis): Cancer spread to distant body parts.
  • M0: No distant spread.
  • M1: Cancer has spread.

Additional Staging Information

• Lowercase Letters: Indicate staging type or occurrence.
  • c (Clinical): Staged before treatment.
  • p (Pathological): Staged post-surgery.
  • y (Post-Therapy): After treatment like chemotherapy.
  • r (Reoccurrence): Indicates cancer recurrence.

Number System

• Stage 0: Cancer in situ, not spread.
• Stage 1: Localized, not spread to lymph nodes.
• Stage 2: Spread to nearby tissues/lymph nodes.
• Stage 3: More extensive spread to tissues/lymph nodes, not distant organs.
• Stage 4: Metastatic, spread to distant body parts.

Conclusion

• End of review on tumor grading and staging.
• Access free quiz through provided link to test understanding.