Thursday July 3rd...Dr. Dodson (4)...Grading and Staging Cancer...

Grading ovarian cancer

Doctors may also assign a grade to the disease. The appearance of the cells gives doctors an idea of how quickly or slowly the cancer is likely to grow. As a normal cell grows and matures, it becomes specialized for its role and place in the body. This is called differentiation. A tumor’s grade uses the letter “G” and a number. It describes how closely the cancer cells resemble normal tissue under a microscope. Cells that look like healthy cells are low grade, and those that look like cancer cells are high grade. In general, the lower the grade, the better the prognosis is. There are 3 grades of ovarian cancer

·         GX: The tumor grade cannot be identified.

·         G1: Describes cells that look more like normal cells (well differentiated/low grade).

·         G2: The cells are somewhat different (moderately differentiated).

·         G3: The tumor cells barely resemble normal cells (poorly differentiated).

·         G4: The cells do not look like normal cells or are underdeveloped are (undifferentiated/high grade).

Staging ovarian cancer

The staging of a cancer tells the doctor how far it has grown and if it has spread. It is important because your specialist will decide on your treatment according to the stage of your cancer.

Doctors use a simple 1 to 4 staging system for ovarian cancer. It is called the FIGO system after its authors - the International Federation of Gynecological Oncologists. Advanced ovarian cancer means cancer from stages 2 to 4. It has spread away from the ovary to other parts of the body. Cancer that has spread to another part of the body is called secondary cancer or metastases. If the doctor finds cancer in the lymph nodes then it automatically becomes stage 3. I then qualify for clinical trials.

Stage 1- ovarian cancer means the cancer is only in the ovaries.

It is divided into 3 groups

·         Stage 1a - the cancer is completely inside one ovary

·         Stage 1b - the cancer is completely inside both ovaries\

·         Stage 1c - as well as cancer in one or both ovaries, there is some cancer on the surface of an ovary or there are cancer cells in fluid taken from inside your abdomen during

surgery or the ovary ruptures (bursts) before or during surgery

Stage 2- means the cancer has grown outside the ovary or ovaries and is growing within the area circled by your hip bones (the pelvis). There may also be cancer cells in the abdomen.  

So stage 2 cancer can be:

·         2a - the cancer has grown into the fallopian tubes or the womb

·         2b - the cancer has grown into other tissues in the pelvis, for example the bladder or rectum

·         2c - the cancer has grown into other tissues in the pelvis (this is the stage where the doctor says I’m at right now) and there are cancer cells in fluid taken from inside your abdomen (I don’t know if there is cancer cells in my fluid though).

Stage 3- cancer of the ovary means the cancer has spread outside the area surrounded by your hip bones (the pelvis) into the abdominal cavity. Your cancer is also stage 3 if cancer is found in the lymph nodes in your upper abdomen (tummy), groin or behind the womb.

So stage 3 cancer can be:

·         3a - using a microscope, cancer growths can be seen in tissue taken from the lining of the abdomen

·         3b - there are visible tumor growths on the lining of the abdomen that are 2cm across or smaller

·         3c - there are tumor growths larger than 2cm on the lining of the abdomen, or cancer in lymph nodes in the upper abdomen, groin or behind the womb, or both

 Stage 4- ovarian cancer means the cancer has spread to other body organs some distance from the ovaries, such as the liver or lungs. But if ovarian cancer is only found on the surface of the liver and not within the liver itself, then the cancer is still stage 3.