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What's the letters after the staging mean?

just4Brooks's picture
just4Brooks
Posts: 987
Joined: Jun 2009

I have been told that I'm a stage 3 Colorectal person. I see many post here that put a letter behind their staging, Like a,b,c, and ect. What's the letters mean?

Brooks

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

There are five colon cancer stages (0-4). Colon cancer used to be rated using the Duke's system. For example, Duke's A cancer was the equivalent of stage 1 cancer. Sometimes you'll still hear people refer to their tumors that way, which can cause some confusion. The following breakdown should help clarify the basics of each colon cancer stage.

Stage 0 Colon Cancer
This is the earliest stage possible and is also called carcinoma in situ. "Carcinoma" refers to cancer that starts in epithelial tissue and "in situ" means original position or place. Colon cancer is considered stage 0 when it hasn't moved from where it started; it's still restricted to the innermost lining of the colon.

Stage 1 Colon Cancer
In this stage, cancer has extended beyond the innermost layer of the colon into the middle layers of the colon. Stage 1 used to be called Duke's A colon cancer.

Stage 2 Colon Cancer
This used to be called Duke's B colon cancer. Colon cancer is considered stage 2 after it moves beyond the middle layers of the colon. Sometimes colon cancer is still considered stage 2 after it has extended into nearby organs.

Stage 3 Colon Cancer
If colon cancer is found in at least three lymph nodes, it has reached stage 3 (formerly called Duke's C colon cancer).

Stage 4 Colon Cancer
Formerly referred to as Duke's D colon cancer, stage 4 is the most advanced colon cancer stage. In general, stage 4 colon cancer has spread to nearby lymph nodes and other parts of the body. Common destinations include the liver and the lungs.

lcarper2
Posts: 638
Joined: Dec 2009

crap I must be a 50xxx I have not been told what stage I was only that I had a large tumor on my colon and my colon was removed and that 34 nodes removed and 19 were cancerous so where does that put me ...lol

Patteee's picture
Patteee
Posts: 950
Joined: Jul 2009

sounds like 3C or stage 4. You didn't say if your colon had been perforated, but with 19 lymph nodes, think they would still say C and not B. If the cancer has not spread to other organs or places, then it isn't stage 4.

lcarper2
Posts: 638
Joined: Dec 2009

they said it had gotten into the wall of my colon buy no other organs were effected c-scan 3 days after surgery said I had no cancer anywhere else not liver or lungs etc.

TLG320
Posts: 168
Joined: Oct 2009

You're a 3c if it's not spread to any other organs. Stage 2 is divided into 2a and 2b depending on whether the tumor is a T3 (which is 2a) or T4 (a 2b); stage 2 means there are no positive lymph nodes. Stage 3 is indicative of lymph node involvement. Stage 3a, 3b, and 3c is determined based on the T stage of the tumor (T1-4) and the number of nodes involved. 3a is a T1 or T2 with 3 or fewer infected nodes. Stage 3b is a T3 or T4 with 3 or fewer infected nodes, and 3c is any T with 4 or more infected nodes. Stage 4 is any T and any number of nodes (infected or not) that has metastized beyond the colon.

Check out this link:

http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_colon_and_rectum_cancer_staged.asp?rnav=cri

vchildbeloved
Posts: 133
Joined: May 2008

I was told that I had 1 out of 18 lymph nodes positive and that made me a stage 3. Very interesting.

Valerie

Patteee's picture
Patteee
Posts: 950
Joined: Jul 2009

I believe stage 3 is the only one that has letters. And it indicates how far the cancer has progressed.

I am 3B- meaning my colon was perforated and 6 (6 or less is the cut off for B) lymph nodes were positive.

3A- no perforation, but lympth node involved.
3C- perforation and more than 6 lymph nodes.

(not positive this is exact, but you get the idea)

If you look at statistics for survival after 5 years, there is a difference been stage 3A and 3C and therefore a need to stage it differently. Personally, I think it is a fine line that is walked between the letters and certainly not an exact science on survival rates. Just a tool.

KATE58's picture
KATE58
Posts: 300
Joined: Nov 2009

MY UNDERSTANDING IS THERE IS SEVERAL
DIFFERENT STAGING TABLES AND IT DEPENDS ON WHICH YOUR DOCTOR
USES.
THERE IS "THE DUKES" WHICH USES "A" FOR IN SITU- B1 IS PENETRATED INTO WALL BUT NOT THRU,-
B2 PENETRATED THRU ,NO LYMPH NODE.-,CI, IS B2 W/LYMPH NODE INVOLVEMENT,- C3 IS B2 WITH LOCAL METS-- "D" IS DISTANT METASTATICS.
CONFUSED YET?
"THE TNM SYSTEM" WHICH IS VERY COMPLICATED, USE TI , T2 ,T3, T4,THEN ADDS NO, NI,N2,N3 --MO ,M1.
SO, STAGE IV ,WITH LYMPH NODE INVOLVEMENT AND DISTANT METS WOULD BE...
T4 N2 M1...I'M NOT SURE DOCTORS CAN KEEP IT STRAIGHT.
I THINK THE DOCTORS DO US A FAVOR BY STAGEING IT.. I,II,III.IV .
EACH STAGE ACTUALLY HAS SUB STAGES.
HOPE THIS HELPED
IT CONFUSED ME TRYING TO EXPLAIN IT (LOL)
MY ADVICE,DON'T WORRY ABOUT IT.

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

A brand new staging system has just begun. I read about it on colon club about a month ago. It actually moved some people from 3c to 3b. There was levels to Stage IV in the new system.

Pet peeve....

I think a tumor that has busted through the colon wall is much more dangerous that someone having 4 instead of 3 lymph nodes involved. Also, you might see someone who had only 4 lymph nodes removed for biopsy with 2 that tested positive and another person who had 100 removed and 4 tested positive. The person with 2 out of 4 is deemed a lesser stage that the person who had a teeny percentage.

Staging doesn't take into consideration the size of the tumor or how aggressive it was. It should include how well defined the cells were. Not all staging models include that criteria.

Honestly Brooks, treatment is the same.

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

Announcement of new staging guidelines:
http://www.cancerstaging.org/news/pressrelease1009.html

Chapter 1 Purposes and Principles of Cancer Staging
http://www.springer.com/cda/content/doc ... p173894221

Chapter 14 Colon and Rectal Cancer
http://www.springer.com/cda/content/doc ... p173894221

Most of the changes just involve breaking previous categories into pairs of sub-categories, but there are a few cases where the staging assignments are actually changed. For those of you who don't want to wade through the pdf documents, or who would rather not be confronted with pages of survival statistics, here's a copy of the list of changes for Colon and Rectal Cancer:

SUMMARY OF CHANGES
● In the sixth edition, Stage II was subdivided into IIA and IIB on the basis of whether the
primary tumor was T3N0 or T4N0, respectively, and Stage III was subdivided into IIIA
(T1-2N1M0), IIIB (T3-4N1M0), or IIIC (any TN2M0). In the seventh edition, further
substaging of Stage II and III has been accomplished, based on survival and relapse data
that was not available for the prior edition
● Expanded data sets have shown differential prognosis within T4 lesions based on extent of
disease. Accordingly T4 lesions are subdivided as T4a (Tumor penetrates the surface of the
visceral peritoneum) and as T4b. (Tumor directly invades or is histologically adherent to
other organs or structures)
● The potential importance of satellite tumor deposits is now defined by the new site-specific
factor Tumor Deposits (TD) that describe their texture and number. T1-2 lesions that lack
regional lymph node metastasis but have tumor deposit(s) will be classified in addition as
N1c
● The number of nodes involved with metastasis influences prognosis within both N1 and
N2 groups. Accordingly N1 will be subdivided as N1a (metastasis in 1 regional node) and
N1b (metastasis in 2–3 nodes), and N2 will be subdivided as N2a (metastasis in 4–6 nodes)
and N2b (metastasis in 7 or more nodes)
● Stage Group II is subdivided into IIA (T3N0), IIB (T4aN0) and IIC (T4bN0)
● Stage Group III:
- A category of N1 lesions, T4bN1, that was formerly classified as IIIB was found to have outcomes more akin to IIIC and has been reclassified from IIIB to IIIC
- Similarly, several categories of N2 lesions formerly classified as IIIC have outcomes more akin to other stage groups; therefore, T1N2a has been reclassified as IIIA and T1N2b, T2N2a-b, and T3N2a have all been reclassified as IIIB
● M1 has been subdivided into M1a for single metastatic site vs. M1b for multiple metastatic
sites

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

Stage 1...........................Sucks

Stage 2............................Sucks

Stage 3.............................Sucks

Stage 4..............................Sucks

Did I say that Cancer Sucks ?.........

chicoturner's picture
chicoturner
Posts: 285
Joined: Apr 2009

Buzzard for the much less confusing clarification! It's exactly what I thought! Jean

ann2008's picture
ann2008
Posts: 119
Joined: Nov 2009

Amen, agree with your system.

vchildbeloved
Posts: 133
Joined: May 2008

AMEN TO THAT!!!!

Valerie

dianetavegia's picture
dianetavegia
Posts: 1953
Joined: Mar 2009

Bumped for a new member

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