Understanding the Stages of Cancer

Receiving a cancer diagnosis can be one of the most challenging and overwhelming experiences a person can face. The journey through cancer is often marked by uncertainty, fear, and a whirlwind of medical information. During these turbulent times, one essential aspect to comprehend is the various stages of cancer. 

Understanding the stages of cancer is not just about medical jargon or clinical classifications; it’s about equipping yourself with the knowledge and insights necessary to navigate this complex terrain. It’s about gaining the ability to make informed decisions, communicate effectively with your healthcare team, and find hope in a journey that may sometimes seem daunting.  

What is cancer staging?

Cancer staging categorises the extent and size of cancer, helping healthcare professionals determine its progression. When cancer is first diagnosed, medical experts perform a series of crucial tests to: 

  • Determine the tumour’s size 
  • Assess whether it has infiltrated nearby tissues 
  • Investigate whether it has metastasised to distant parts of the body 

Cancer staging isn’t just about size and spread, though; it can also involve considering the grade of the tumour, which relates to how closely cancer cells resemble normal cells. 

Types of staging systems

Cancer staging relies on two primary systems: the TNM system and the number system. These systems serve multiple crucial purposes: 

  • Providing a common language:
    Doctors use these systems to ensure a consistent terminology for describing the extent and progression of cancer. 
  • Comparing treatment outcomes:
    Medical professionals rely on staging to compare the effectiveness of treatments across various research studies. 
  • Standardised treatment guidelines:
    Staging helps establish standardised treatment guidelines in different healthcare facilities and hospitals.

The TNM system

The TNM system, representing Tumour, Node, and Metastasis, provides a detailed framework for characterising cancer.

Let’s break it down:
T(Tumour): This component evaluates the size of the tumour and the extent of its invasion into nearby tissues. It’s classified from 1 (small tumour) to 4 (large tumour).
N(Node): N assesses whether cancer cells have reached the lymph nodes, categorised from 0 (no cancer cells in lymph nodes) to 3 (numerous lymph nodes with cancer).
M(Metastasis): M checks if cancer has spread to other parts of the body, either 0 (no spread) or 1 (metastasis present).

For example, if you have a small cancer extending to the lymph nodes but not spreading further in the body, it might be classified as T2N1M0. In contrast, a more advanced cancer with significant local invasion and widespread lymph node involvement could be designated as T4N3M1.

Number staging system

Derived from the TNM system, number staging systems help categorise cancer into different stages. These stages are typically numbered from 0 to 4 and are often represented using Roman numerals, such as IV for stage 4.

Stage 0: This indicates cancer in its initial, localised stage (in situ) without spreading beyond its original site.
Stage 1: Cancer at this stage is relatively small and hasn’t extended to other body parts.
Stage 2: The tumour has grown but is still confined to its site of origin without metastasis.
Stage 3: Cancer at this stage is more prominent and may have started to invade surrounding tissues or lymph nodes, crucial immune system components.
Stage 4: This stage signifies advanced cancer, spreading from its primary site to at least one other organ in the body, commonly referred to as ‘secondary’ or ‘metastatic’ cancer.

Cancer grades

Cancer grades are assigned based on the microscopic appearance of cells, influencing the pace of growth. Here’s how it works: 

Grade 1: Cancer cells closely resemble normal cells and exhibit a slower growth rate. 
Grade 2: These cells look different from normal cells and tend to grow faster than normal ones. 
Grade 3: In this grade, cancer cells appear highly abnormal and have the potential to grow and spread more aggressively. 

 Understanding the stages and grades of cancer is a significant step in your journey, helping you and your healthcare team make informed decisions about treatment and care. While it may seem overwhelming, remember that you’re not alone, and support and guidance are available every step of the way.

This blog post is for informational purposes only and should not be considered medical advice. Please consult with a healthcare professional for personalized guidance.  


Stages of cancer 2023, Cancer Research UK, viewed 18 October 2023,

What do cancer stages and grades mean? 2021, NHS, viewed 18 October 2023,  
< https://www.nhs.uk/common-health-questions/operations-tests-and-procedures/what-do-cancer-stages-and-grades-mean/> 

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