Receiving a cancer diagnosis can be overwhelming – the sudden rush of medical jargon, tests, appointments, information, and decision-making can make your head spin. It is only natural that you have questions about what it all means for you and for your family.
You may wonder if your cancer is serious, for example, and worry if you will be okay. All of these concerns are valid, and your cancer care team will try to address them as clearly and as thoroughly as they can.
Understanding your cancer diagnosis and learning a few key medical words can help you get a better idea of what is happening and what may lie ahead.
Cancer specialists “grade” cancer according to how the cancer cell appears under a microscope; the cell’s can provide clues about how quickly the cancer will likely grow and spread. Grade 1 cancer cells look similar to normal cells and are organized like normal cells; grade 3 and 4 cancer cells look quite different. Grading systems can differ between the various types of cancer. When grading breast cancer, pathologists often use the Nottingham grading system that looks at the size and shape of the cancer cells' nucleus, for example; they use the Gleason scoring system that looks at the organization of cancer cells when grading prostate cancer.
Cancer stage is the size and/or extent to which the cancer has spread. To stage cancer, doctors consider the location of the primary tumor, its size, whether it has spread to nearby lymph nodes, and the number of tumors present. Treatment often depends on the type of cancer and the extent to which it has spread.
Cancer specialists often use the TNM system to stage cancers that form solid tumors, such as breast, colon, and lung cancers. The system helps doctors describe the primary tumor where the cancer started and whether the cancer has spread, or metastasized, to other tissues and organs in the body.
TNM is an abbreviation that stands for:
Doctors combine the TNM classifications to determine the stage of a cancer. Most cancers have four stages, although some types of cancer also have a fifth stage, known as Stage 0 (zero).
Stage 0: The cancer is in situ, which means the cancer cells are still located where it started, and that the cancer has not invaded nearby tissues
Stage I: Also known as early-stage cancer, Stage I cancer describes a small tumor or patch of cancer cells that have not grown deeply into nearby tissues and has not spread to lymph nodes or other parts of the body
Stage II and III: Describes larger cancer or tumors that have grown more deeply into nearby tissue, and have spread to lymph nodes, but have not metastasized to other tissues or organs of the body
Stage IV: Also known as advanced or metastatic cancer, Stage IV cancer has spread to other organs or parts of the body
Staging varies, depending on the type of cancer. For example, leukemia, lymphoma, multiple myeloma, and other cancers of the blood use a different staging system since they do not form solid tumors.
If you are like most patients who have just received a cancer diagnosis, one of your first questions is, “How likely am I to beat this?”
While cancer doctors cannot predict the future, they can make an estimate based on the experiences of other people with the same type of cancer. Some types of cancer are more aggressive than are others, for example, and other types of cancer spread more slowly. After doctors diagnose cancer and create a treatment plan, they can often offer a prognosis, which is the most likely outcome.
Cancer specialists, known as oncologists, also use other factors to make the prognosis. Specifically, the factors affecting your prognosis include:
Cancer statistics gathered by researchers over the years provide insight into your prognosis. Doctors use statistics about people with the same type, stage, and treatment to estimate your prognosis.
It is important to know that a prognosis is merely a probable outcome- based on the average outcome from a sample of people with your type of cancer and other similar factors. It does not mean that your outcome will be the same.
Understanding your type of cancer and prognosis can help you and your loved ones explore the various treatment options, manage the side effects of treatment, and learn new ways of taking care of yourself.
How much you learn about your cancer diagnosis and prognosis is up to you – some people prefer to learn all they can, while others find that information confusing or frightening. If you decide that you want to learn more, your oncologist, cancer care team, and our website are a great place to start. They can provide you with reliable information, explain what the statistics mean, and discuss your prognosis.
Coping with a prognosis can be difficult, especially if you don't have a support system.. If you need help managing the emotional, psychological and social challenges relating to your diagnosis, contact our oncology social workers at Willamette Valley Cancer Institute. We provide one-on-one counseling and may be able to help you connect with support groups, financial aid, and other assistance you may need.