Understanding your cancer diagnosis

Diagnoses come in many forms and use shorthand that can be difficult to comprehend. It is important to understand a cancer diagnosis in order to fully comprehend what measures should be taken in both treatment and daily life. The choice of treatment is a personal decision, and after discussing all the options with a medical professional, should be based on health and needs of the patient. It is important to understand the diagnosis before making treatment decisions.

Pathology Report

Pathology reports are official documents which describe the results of laboratory tests and cell evaluations. Tissue is taken from the patient’s body and studied meticulously in order to provide an accurate representation of the spread and extent of cancer throughout the body.

This report contains information about whether the tissue contains a tumor which is cancerous or non-cancerous. Cancerous tumors are malignant and can invade nearby tissue. Benign tumors are non-cancerous and are less harmful but can still cause complications if located near vital structures.

The microscopic description of the specimen contains more details about the tissue. This information is important in diagnosing and treating cancer. It contains:

Information on whether the cancer is invasive. Non-invasive cancers, marked “in situ,” have not spread outside of the tissue where they began. Though they can become invasive, these cancers are considered lower-risk. Invasive cancers spread or metastasize throughout the body.

Grade. This figure measures the difference between a patient’s healthy cells and diseased cells. Though the measurement varies by the type of cancer, in general lower grades show a smaller difference and indicates a better prognosis.

Mitotic rate. This figure measures how quickly cells are dividing. A lower rate indicates a better prognosis.

Tumor margin. This figure indicates whether cancer cells are at the margin of the sample. A “positive” or “involved” margin indicates that cancer cells are at the margin and are therefore in the rest of the body.

Lymph nodes. A “positive” spread indicates that the cancer has spread to the lymph nodes. This figure will most likely not be included in the report if the results came back negative.

Staging figure. Each type of cancer is sorted into a stage group which details the severity of the cancer and aids doctors in finding a prognosis.

TNM figure. This figure describes cancer growth, location and spread.

Other sections include a summary of treatment options and recovery, sampling differences and comments about the nature of the cancer.

Staging

Cancer staging is a summary of the extent of the cancer’s reach. This diagnosis is based on a series of tests including laboratory and imaging tests.

Doctors use stage rankings in order to assess the best course of action in treatment and to form a prognosis. The clinical stage, which is found before treatment begins, is used throughout the entire treatment process, even if the cancer grows or spreads. The pathological stage, which is through treatment, is considered a better assessment of the spread and extent of the cancer.

The TNM system is often used to specify details that are important to both diagnosis and treatment. This rating is most likely released in the pathology report and is an important aspect of understanding treatment options. It has three distinct components:

Tumor: indicates the size and location of the tumor.

Node: indicates whether cancer cells have spread to the lymph nodes.

Metastasis: indicates whether the tumor has spread to other parts of the body.

These factors are used to determine the cancer’s stage group, which is ranked on a scale of 0-IV depending on the nature of the cancer. These stage groups connect to a patient’s prognosis. Generally, earlier stages have a better prognosis.

Stage 0: the cancerous tumor is highly unlikely to spread.

Stage I: the patient has small primary tumors that have not spread to the lymph nodes.

Stage II and III: tumors are smaller and may have spread to the lymph nodes

Stage IV: cancer has spread to distant sites.

Certain types of cancer may operate on a five-group scale, with stage V being the most severe.

Prognosis

A prognosis is the doctor’s estimate for a patient’s likelihood of survival. Many factors affect a prognosis, making it impossible to find with complete certainty.

Furthermore, a prognosis is based on general statistics. These statistics are taken from patients with a similar TNM, stage and health preceding treatment. Though prognoses are based on the most recent statistics and are considered the best system currently in place, they are based on averages and therefore should be accepted with a degree of uncertainty. Many patients’ cancer does not behave in the way predicted, making these prognoses merely an estimate.

Though a patient’s doctor will recommend a course of action based on the prognosis, in the end, the decision about treatment is up to the patient and is deeply personal. Typically, patients must ask to be told about survival statistics.

Cancer-specific survival statistics measure the survival statistics of individuals with the same type of cancer. These statistics typically only measure patients who seek out treatment. Individuals who choose to forego treatment or to use more uncommon treatment methods may not have accurate statistics available to them.

Relative survival statistics compare the survival of cancer patients after treatment to that of an individual without cancer.

Overall survival statistics detail the number of people who have not died of any cause for a set number of years after treatment.

Disease-free, recurrence-free or progression-free survival statistics detail the percentage of patients who have no signs of cancer for a set number of years after treatment.

These details largely depend on the likelihood that the patient’s cancer will respond to treatment and on how easy it is to control.

Doctors are always willing to answer any questions patients may have and to give the most up-to-date information available about treatment options.