01 November 2021, Monday
What is Bone Cancer Staging?
Overview:
In simple words, staging is a system to determine the extent of cancer in the patient and the level of risk posed to the patient due to it. Stage of the cancer at diagnosis, is the best predictor of survival and is a powerful guide to the optimal treatment of the disease.
One of the most important pieces of information derived from staging investigations is whether the disease is localized or metastatic. The importance of staging is that, treatment strategies can be specifically planned to the patient’s situation, to get the best outcome.
In simple words, staging is a system to determine the extent of cancer in the patient and the level of risk posed to the patient due to it. Stage of the cancer at diagnosis, is the best predictor of survival and is a powerful guide to the optimal treatment of the disease.
In cancer management, after a diagnosis of cancer is made, a set of tests are carried out to stage the cancer. Staging may involve several investigations like histopathology, MRI, CT scan, Bone scan, PET scan, etc.
The exact set of investigations varies from case to case and will be decided by your treating doctor. Staging criteria may differ slightly for different tumors. One of the most important pieces of information derived from staging investigations is whether the disease is localized or metastatic.
It is possible that the patient may have the disease in other parts of the body, but is not aware of it as they are small in size and therefore, are not causing any problem at this moment. Staging investigations help in locating and identifying these metastatic foci of disease early.
This helps in choosing the most useful and effective treatment approach to such a patient, giving due consideration to the presence of any metastasis and its treatment. The importance of staging is that, treatment strategies can be specifically planned to the patient’s situation, based on the stage of the disease, to get the best outcome.
For bone sarcomas, there are two major staging systems. One is the MSTS (Musculoskeletal Tumor Society) staging system, which classifies these conditions into three stages, with stage ‘I’ being the lowest, offering the best prognosis to the patient and stage ‘III’ representing the highest, indicating metastatic disease and consequent poor prognosis.
The other staging system is the AJCC (American Joint Committee on Cancer) staging system (also called the TNM System) which classifies these diseases into four stages with stage ‘I’ being the lowest, offering the best prospect for recovery and stage ‘IV’ denoting the highest, indicating metastatic disease, suggesting the least chance of a least favourable outcome.
Why Cancer Staging Is Necessary in Bone Cancer?
Treatment strategies are different for patients in different stages of the disease, including those with localized cancer and those who have metastatic cancer. By considering various criteria, staging not only helps in identifying patients with metastatic disease, but it also helps in identifying people with non-metastatic disease who have a higher risk than some others with localized disease.
Knowing that a patient has metastatic sarcoma makes it possible to employ a more aggressive treatment plan to deal with the metastases along with the primary tumor. The stage of the disease at diagnosis is one of the important details, which help in predicting the likelihood of recovering from the condition.
The need for staging is obvious once you understand the behaviour of malignant tumors. Malignant tumours are those tumours that have the ability to spread locally (invasion), and to distant organs and tissues (metastasis).
Treatment strategies are different for patients in different Stages of the disease, including those with localized cancer (non-metastatic cancer – disease, which has not spread to distant locations) and those having metastatic disease (cancer which has spread to distant organs/tissues).
By considering various criteria, staging not only helps in identifying patients with metastatic disease, but also helps in identifying people with non-metastatic disease who are at a higher risk than some others with localized disease (e.g. due to a higher grade of tumor, larger size of the disease, etc.).
AJCC ‘Stage I’, ‘Stage II’ and ‘Stage III’ disease, all represent localized sarcoma, but with increasing levels of risk to the patient due to higher grade of disease, larger size of disease, etc. A patient with localized disease, but with a higher Stage, is at a higher risk of relapse of disease as compared to one with a lower Stage, and therefore, requires more radical or aggressive treatment.
Knowing that a patient has metastatic sarcoma makes it possible to employ a more aggressive treatment plan to deal with the metastases along with the primary tumor. If staging investigations are not done, metastasis (if any) may remain unknown for a long time, until it becomes large and causes symptoms.
A potentially treatable metastasis may thus become untreatable, if not detected in time and treated appropriately. Sometimes, in patients with extensive disease, staging may help avoid unnecessary unhelpful treatment.
The ‘Stage of the disease at diagnosis’ is one of the important details, which helps in predicting the likelihood of recovering from the condition. Generally, lower the Stage of the disease, better is the prognosis; higher the Stage, worse is the likely outcome.
Further Reads:
What is the difference between ‘Grade’ of the disease and ‘Stage’ of the disease?
APPOINTMENT FORM
Dr. Chetan Anchan
MS - Orthopaedics, Diploma in Orthopaedics,
FCPS - Mid. & Gynae, MBBS
About Author - Dr. Chetan Anchan is an expert and well known orthopaedic surgeon and oncologist from Mumbai. He has a vast experience in treating all types of Malignant and Benign, Bone and Soft Tissue Tumors, and Skeletal Metastases.
To book an appointment, call: +91 – 93244 27302
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