A organ can give rise to various tumour types, according to the cell type of origin. The cell type may influence treatment options, and prognosis. The cell type is determined by pathological examination of biopsy material.
A tumour stage describes the extent to which a tumour has invaded from its origin. A tumour first invades within the organ of origin (prostate, bladder or kidney etc). It may then extend beyond the organ into adjacent surrounding tissues or adjacent organs. The extent of the primary tumour is described by a “T” stage category (e.g. T1, T2, T3, T4), and the meaning of the code is specific for the organ of origin. Cancerous cells may jump to other parts of the body (when it is then called a Metastasis). This may be local lymph glands (assigned a “N” category, or more distant tissues, most commonly bone, lung, liver (“M” category). The extent of the spread can usually be determined X-rays, CT scan, and bone scan.
Tumours are graded from tissue biopsies by pathologists. The grade describes the microscopic appearances of the tumour and relates to their biological behaviour. Grading is most important for tumours that have not yet spread, rather than tumours that have been seen to have spread by tumour staging investigations.
As a general rule, lower numbers for tumour grade indicate less aggressive tumours and better prognosis. Prostate cancer is graded by Gleason Grade, consisting of two numbers each between 1 and 5 that are added together to give a “Gleason Sum Score” (between 2 and 10, e.g.”3+4”). Bladder cancer is graded from 1 – 3. Kidney cancer is graded by Fuhrman Grade (1-4).
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