number of surrounding lymph nodes shown to be cancerous. M indicates whether the cancer has metastasized from the primary tumor to other areas of the body. Using the TNM system, each letter is followed by a number that gives more detail about cancer, for example, T1N1M0 . See Tables 1-3 which further explain these designations. Table 1: Descriptions of the T Category in the TNM System The T category describes the primary tumor using a second digit to indicate more detail. TX Primary tumor cannot be evaluated or measured. T0 No evidence of the primary tumor. Tis Cancer in situ (early cancer that has not spread to surrounding tissue). T1, T2, T3, T4 Size and extent of primary tumor; higher number indicates larger tumor or spread into nearby tissue. Table 2: Descriptions of the N Category in the TNM System The N category describes whether or not cancer has spread to nearby lymph nodes. NX Cancer in nearby lymph nodes cannot be evaluated or measured. N0 No cancer found in the nearby lymph nodes. N1, N2, N3 Refers to the number and location of involved lymph nodes; higher number indicates more lymph nodes that have cancer. Table 3: Descriptions of the M Category in the TNM System The M category describes whether there is distant metastasis present in other areas of the body. MX Metastasis cannot be measured. M0 Cancer has not metastasized to other areas of the body. M1 Cancer has metastasized to other areas of the body.
While the TNM system offers significant detail, physicians often group cancers into five less-detailed, basic stages when discussing the conditions with patients (Stage 0 – IV): ● Stage 0 : Means that abnormal cells have been found, but they have not spread into nearby tissue. This is also called carcinoma in situ (CIS) . Some controversy exists regarding whether CIS is cancer, but the cells may become cancerous. ● Stages I, II, & III : Mean that cancer is present; higher numbers indicate larger tumors that have spread to surrounding tissues. ● Stage IV : Means that cancer has spread from the primary tumor to distant areas of the body. According to the National Cancer Institute, there are a few other terms that healthcare providers may use to describe cancer: ● In situ : Abnormal cells are present, but they have not spread into surrounding tissue. ● Localized : The cancer is limited to the area around the primary tumor with no sign that it has spread to other areas. ● Regional : Cancer has spread to lymph nodes, tissues, or organs near the primary tumor. ● Distant : Cancer has spread to distant areas of the body. ● Unknown : Not enough information is available to determine the stage of cancer. The stages of non-Hodgkin lymphoma (NHL) are slightly different from those of other types of cancer. They describe the area of the lymphatic system that is affected and whether organs are involved: ● Stage I : Is the early stage of the disease where the cancer is found in only one lymph node region or in one organ. ● Stage II : Is a slightly more advanced cancer that is localized to two or more lymph node regions on one side of the diaphragm. ● Stage III : Is an advanced form of the disease and it involves lymph nodes both above and below the diaphragm. ● Stage IV : Describes NHL that has advanced beyond the lymph nodes and spleen, as well as into one or more organs, including the skin, liver, bones, or bone marrow.
TREATMENT OPTIONS FOR CANCER
Treatment options depend on the type of cancer and the stage of advancement. They include radiation therapy, surgery, chemotherapy (non- specific and targeted), immunotherapy, and hormone therapy. Some patients receive only one type of treatment, but others may receive combinations of treatments, Radiation therapy Radiation therapy employs ionizing radiation to kill cancer cells, prevent it from recurring, or to slow its growth. It is used as part of the treatment plan for most solid tumors, but it can also be combined with other treatment strategies. The two main types of radiation therapy are external beam radiation therapy and internal radiation therapy. In external beam radiation therapy, a beam of radiation is emitted from a machine that aims it at the tumor. This method treats specific parts of the body, such as the lungs, instead of treating the whole body. Internal radiation therapy involves putting a radioactive material in the body in the form of a solid or liquid. Taking internal radiation therapy as a solid, called brachytherapy, Surgery Surgery is performed on many patients diagnosed with cancer, but it is most effective for removing solid tumors. The type of surgery depends on the type of tumor, its location in the body, the amount of tissue to be removed, and the purpose of the
for example, surgery with chemotherapy. Clinical trials of new treatment protocols may be available to some patients, but it is important that they understand the possible risks before participating.
usually takes the form of capsules, seeds, or ribbons. It is used to treat cancers of the head, neck, breast, prostate, cervix, and eye. When internal radiation therapy is given as a liquid, it is delivered through an IV line. Liquid internal radiation treatments are most often used to treat thyroid cancer. Radiation therapy can be implemented as the only treatment for some patients, but it can also be used to augment other treatments. It may be used to shrink a tumor before surgery or to kill any remaining cancer cells after surgery. A technique called intraoperative radiation allows physicians to deliver radiation therapy directly to the tumor without passing through the skin.
surgery. Surgical procedures may be open or minimally invasive. The open procedures are similar to other types of open surgeries where the surgeon must cut through healthy tissue to get to the tumor. The surgeon will usually remove a sample of lymph nodes
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