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Staging and Prognosis
(By Leonard Wartofsky, M.D. Reprinted, with permission, from page 33 of Chapter 4 of the reference book “Thyroid Cancer: A Guide for Patients,” (Douglas Van Nostrand, M.D., Gary Bloom, and Leonard Wartofsky, M.D., editors. See http://www.thyca.org/TCGuide.htm)
What is meant by the "stage" of a tumor?
The "stage" of a disease, or in this case of cancer, refers to a phase in the course of the tumor when it has reached some defined level of extent. The extent of the tumor is a measure of its size and whether it has spread elsewhere.
As thyroid cancers grow, they are first confined to the thyroid gland, may then extend in variable degrees to the region of the neck outside the thyroid gland (for example, to the lymph nodes), and finally some types of thyroid cancer will spread to distant sites of the body.
The process of "staging" was developed in order for physicians to more accurately describe the extent of disease in a given patient in objective and standardized terms. This then permits your physician to communicate accurately with other physicians about the degree of disease present and also to better select therapeutic approaches based on published literature on results of treatments in comparably staged patients.
Does stage affect prognosis?
Consulting the literature allows your physician to better predict the potential outcome of how you may fare with your tumor based on the results seen in hundreds or thousands of other patients at the same stage of disease.
This prediction of outcome relates to "prognosis," which is a forecast of what is expected to come (based on the nature of disease present) and is usually given in terms related to life expectancy, or the likelihood of either full cure, remission, possible residual but non-life-threatening persistent disease, or, in the worst case scenario, of death.
Tumors classified as Stage I or II are typically considered to be "low risk" tumors with excellent to good prognosis, whereas Stage III or IV tumors are often described as "high risk," implying a higher risk of residual disease after initial treatment, or recurrence.
Fortunately, the overwhelming majority of patients will fall into Stages I and II and have an excellent prognoses with little risk for recurrence or death from their disease.