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Bone Cancer Stages


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Bone cancer stages vary with time. It is extremely important to detect bone cancer in its initial stages. Often normal diagnosis or physical examination fails to discover the bone cancer.

It happens that the patient comes in with complaints like recurring or radiating pain or pain during physical activity. Diagnosis like x-ray reveals bone fractures or bone deformities or degeneration. Further investigation is needed in this cases .So doctor will ask for blood and bone biopsy reports or even bone scans. If tumor is detected, it can shows bone cancer signs.

Bone Cancer Stages Based on the bone cancer imaging, biopsy and blood tests, the staging of the cancer is determined. These tests will decide the extent of presence of tumors, lymph nodes and whether it is benign or malignant cancer. This will also help decide if the cancer is of type primary or secondary bone cancer.

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The AJCC (The American Joint Commission on Cancer) has described the TNM system to stage bone cancer. Here T is for tumors, L for lymph nodes and M for metastasis (cancer that has spread).

Based on the rate of growth of the tumors or spreading of the cancerous cells, a grading system is also defined. In it, G stands for the grade of the tumor. G1-G2 stands for low grade cancer and G3-G4 stands for high grade cancer.

Based on the data of microscopic and imaging studies, the cancer is analyzed for each category of T, N, M and G.

More about the TNM System:

T Rating: T is rated as T(X) where X is a number between 0-3 T0 shows that is no or little evidence of primary tumor. It indicates that there is no primary tumor is expanding to surrounding local tissue. Ratings such as T1-T3 show that the size or extent of the tumor is increasing

N Rating: N is rated as N(X) where X is between 0-1. It indicates the presence, the effects and involvement of the local lymph nodes. A rating such as N1 shows evidence of local lymph node that are affected or causing nearby damage. A rating such as N0 shows local lymph nodes that are not affected by cancer

M Rating: M is rated a bit differently. M stands for metastasis. M0 means there are no signs of metastasis or no signs that cancer is spreading. M1 means that the cancer has already spread to other parts of the body.

Metastasized cancer can also described be as M1a or M1b. M1a means that the cancer is affecting sites like lungs whereas M1b means that the cancer is affecting other crucial organs.

Bone cancer can also be grouped by the Enneking staging system as,

  • Low grade and no spreading
  • High grade and no spreading
  • Spreading to other organs

About Stage 1: Stage 1 bone cancer is low grade and does not spread. Minor surgery and chemotherapy and radiation therapy may kill the cancer. Stage 1A bone cancer is low grade and of primary nature, that is, inside the bone or intra-compartmental bone cancer. It does not break through the bone walls and usually causes swelling. Stage 1B bone cancer is low grade, but it crosses the bone wall and is called an extra-compartmental. It manages to break through the bone wall.

About Stage 2: Stage 2 bone cancer is high grade and growing fast. Ewing's Sarcoma is common example of stage 2 cancer. In such cases, immediate chemotherapy or radiation therapy is advised along with bone surgery. Similar to stage 1a and stage1b, we have stage 2a and stage 2b bone cancer. It simply denotes intra-compartmental and extra-compartmental bone cancer, respectively.

About Stage 3: Stage 3 describes a highly spread cancer. It affects multiple organs, tissues and cartilage around the bones and also other parts of the body. This is a severe stage and requires critical and immediate surgery

Staging for bone cancer: The TNM ratings and grade ratings provide a system for further classification of the bone cancer

Stage I: Limited to the bone and non aggressive
Stage IA: The tumor size around 8 cm. (Rating T1N0M0 G1/2).
Stage IB: The tumor size greater than 8 cm. (Rating T2N0M0 G1/2).
Stage II: High grade with potential to grow
Stage IIA: The tumor size around 8 cm. (Rating T1N0M0 G3/4).
Stage IIB: The tumor size greater than 8 cm. (Rating T2N0M0 G3/4).
Stage III: High grade and affecting multiple places in the same bone (Rating T3N0M0 G1-4)
Stage IV: Cancer that has spread to any other organs from the bone. It can have any rating.

Life expectancy is different for different bone cancer stages. Bone cancer stages thus give a clear understanding of the nature and extent of the bone cancer. They are essential to decide the course of treatment

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