DIAGNOSIS AND STAGING OF CANCER
By Antin. Diagnosis of primary Cancer is according to the location and cell type which have uncontrolled growth / divide uncontrollably. Cancers diagnosis is named by the primary site of origin, i.e., skin, colon, breast, brain, etc. If a cancer is found in the cervix that originated in the lung the diagnosis is cervix cancer metastasis to the lung, not a cervix cancer. Cervix cancers are those that originated from a cervix cell in the cervix. If a cervix cancer spreads to the lung diagnosis still cervix cancer, not lung cancer. Some cancers have little potential to spread; others are very unpredictable and can spread even before the primary site can be determined.
The diagnosis of cancer usually requires that a tissue specimen be removed (biopsy) and sent to a pathologist. The pathologist examines the specimen microscopically to determine if it is cancer and if so diagnosis of cancer can be determined i.e., primary site and type. He should also indicate the grade. Most cancers are graded as to how much they look like the original tissue. If they look a lot like it then they are called well differentiated. If they do not look much at all like it, then poorly differentiated. In general, the diagnosis of well differentiated cancers is expected to behave the best, poorly differentiated the worst.
Following diagnosis, the next step is determined stage of cancer. Stage refers to the extent of the cancer. Each cancer, by organ, has its own staging system. Staging can be designated by one of four stages: Stage I, II, III, or IV. Stage I usually indicates the size of the cancer and that it has not spread beyond the structure of origin; stage II that it has spread into adjacent tissue; stage III that it has spread beyond its own region; stage IV that it involves another organ or a distant site. The official staging system for accredited cancer registries is the TNM system. T indicates the size of the primary tumor. It is usually subdivided into four sub stages. N indicates the status of the regional lymph nodes (the presence of cancer cells). M if distant sites are involved. Stage is assigned by physical examination, x-rays, and sometimes by exploratory surgery. It all depends on what type of cancer is involved.
The important thing about diagnosis and stage is that it determines the appropriate treatment, provides a prognosis, and allows for comparison of treatment results between different treatments and between different institutions.



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