what is the difference between T2 and 2B adenocarcinoma

cabbott said:

Staging is confusing
Doctors have their own language to describe cancer that means alot to them and leaves most of us (well, at least me anyhow) confused and in the dark about what they are saying. I have to look up almost all the terms they use. I have already looked back at a quote on staging cancer that I put in an earlier post concerning staging on this site three times already and I still can't remember exactly what it said, so I'm going to try pasting and cutting to get this right. (Feel free to check out a search engine or a doctor to make sure I have it correct. I'm not a doctor).

Both the terms T2 and 2B are used to describe Non-Small Cell Lung Cancer, also known as NSCLC. The doctors use the T to stand for Tumor and base its rating on the tumor size and how far it has spread withing the lung and to nearby organs. They also have two other initials in their system : N for the spread to lymph nodes and M to stand for metastasis which means a spread to distant organs away from the lung. They may have used them in their report or when they talked to you. By the way, if you don't have a written copy of their report, ask for it and start collecting those reports in a ring binder. It will help you check things out and share information with all the medical folks you see.

Anyhow, the first thing they do is figure out the T, N, and M part that describes the different aspects of the patient's cancer. Then the doctors look on a chart to determine what stage of cancer the patient is in. That helps them determine what treatment the patient needs. These stages have names like 1A or 2B or Stage 4. The bigger the numbers, the more serious the cancer is. But always remember that all cancer can be treated, even stage 4.

T2 specifically means that one or more of the following characteristics are true about the tumor the patient has:

1. It is larger than 3 cm
2. It involves a main bronchus, but is not closer than 2 cm (about ¾ inch) to the point where the trachea (windpipe) branches into the left and right main bronchi
3. It has spread to the visceral pleura
4. The cancer may partially clog the airways, but this has not caused the entire lung to collapse or develop pneumonia

2B means that the patient's cancer has the following characteristics: T2 N1 M0 or T3 N0 M0

I just explained the T2 stuff above. N1, which has to do with the spread to the nodes, means this: The cancer has spread to lymph nodes within the lung, hilar lymph nodes (located around the area where the bronchus enters the lung). Metastases affect lymph nodes only on the same sides as the cancerous lung.

MO means no distant spread. This is obviously good news.

If your head is starting to spin, ignore all the specifics and understand that both doctors are telling you the same thing. There is no spread to distant organs, but the tumor has been moving into the nodes around the lung and getting too big to ignore. Treatment is needed. I am sure that your one doctor concentrated on the "T2" part because that is the most serious part of those three letters. I can tell that because its number is the biggest (the N was 1 and the M was 0). I can't tell which characteristic or characteristics defined the cancer as T2, but you can check the report to determine that.

Let me know if you have questions about this still.

C. Abbott