Once your doctor has made a diagnosis of cancer, it is important that they assess the extent (or stage) of the cancer. Staging a cancer is important because it helps doctors to choose the best treatment for you. It also gives information about the chances of cure. The TNM (Tumour, Node, Metastases) system is used to stage cancer. This system is used to summarise information about the size of the cancer and whether it has spread to lymph nodes at other parts of the body.
Staging is complicated but in broad terms cancers may be described as:
Early stage cancer (Stage I or II cancers), which are small (less than 4 cm) and have not spread. This does not apply to cancer of unknown primary because by definition they have spread.
Advanced stage cancer (Stage III or IV cancers), which are more advanced due to their size (more than 4 cm) have spread to nearby parts of the body, the lymph nodes, or other parts of the body. All cancers of unknown primary are stage III or IV.
The chance of cure depends on both the type of cancer and the stage. It is important to know that most patients with cancer of unknown primary (even stage III or IV) can be cured.
Your doctor may also be interested in the grade of the cancer. Grading refers to the growth pattern of the cancer. The grade of the cancer is determined by a pathologist who examines a biopsy sample under a microscope. The pathologist determines the grade of the cancer by how the cells look. The grade can be used to estimate how quickly the cancer is likely to grow and spread. Grading is usually determined by a biopsy sample of the primary cancer and therefore is not very important in cancer of unknown primary.
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