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Staging Question

Jilgirl's picture
Jilgirl
Posts: 7
Joined: Aug 2013

I'm wondering what is the difference between nx and mx vs no and no? If the nodes or metastasis cannot be assessed how do you know you are a stage 1?

 

angec's picture
angec
Posts: 621
Joined: Mar 2012

Usually it means there were no nodes or mets found on ct scan or during surgery. Stage one is a great place to start.  They can tell if the mass was small, the grade of the mass etc.  Do you have your path report? It can give us more information to help you.  Hopefully surgery was the cure for you or your loved one!  XX

todd121
Posts: 575
Joined: Dec 2012

It's a great question!

Nx means it can't be evaluated if it has spread to regional lymph nodes (by the pathologist, because he/she didn't get any to look at probably). N0 means it has not spread to regional lymph nodes. N1 means it has. If they didn't take any lymph nodes, they can't be evaluated by the pathologist, so they put NX. Usually they won't take any if they didn't note any on the CT and no reason to think they need to take any (lack of other mets, for example, usually they don't take any nodes).

M0 means it has not metastasized, M1 means it has. The pathologist usually will put MX (meaning it's unknown if there are other tumors in the body) unless they have verified that there is another tumor location outside of the primary one in the kidney. I would doubt a pathologist would ever put M0 (a radiologist, surgeon, or oncologist on the other hand would, and they'd mean that they don't know of any, not that there definitely aren't any...)

Stage I means they haven't seen any other evidence of tumors on CT scans other than the one in the kidney, and it's small enough to be contained in the kidney and it's less than 7 cm in size. And they have no evidence of other tumors where they've looked and how they've looked...

They can only stage based on what they know/see. If they didn't scan somewhere, they actually don't know if there's a metastasis there or not. It could also be too small to detect.

Living in the unknown is one of the things that is tough with this disease.

How did that thing with Rumsfeld go? "There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don't know. But there are also unknown unknowns. There are things we don't know we don't know."

You raise the last part. They don't know. They are just saying what they do know. :)

I went into my surgery being told I was Stage I by the surgeon, and came out Stage 3a after the pathologist got done looking at my tumor because it had invaded some of the tiny veins in the kidney, gaining access to my blood supply. I could be Stage 4 now, and they/we may just not know about it.

Todd

 

Jilgirl's picture
Jilgirl
Posts: 7
Joined: Aug 2013

Todd, thanks for the reply. I have every reason with my path report to believe I'll never have to go through this again. However, I have a large visible growth on my left rib and I have many of the same symptoms I experienced before my nephrectomy. My doc does not believe it is cancer but he did order 5 different tests. The question about staging makes me wonder if the urologist made a mistake. My first report noted several nodes on the scan and radiologist said he could not rule out mets. The urologist did not remove any of the nodes because they looked ok. In any case I get my results tomorrow so I should have a answer to my questions. Say a prayer as I'm pretty anxious about this appointment. 

 

todd121
Posts: 575
Joined: Dec 2012

I did say a prayer for you. I hope it's something else and something minor. Let us know please.

Todd

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