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Understanding Your Stage of Esophageal Cancer

Understanding Your Stage of Esophageal Cancer

Your doctor recommends tests and does exams to help determine the stage of cancer. Stage is the word doctors use to describe the size of a cancerous tumor and where and how far it has spread. The first place cancer is found in the body is called the primary site or primary tumor. When a cancer spreads, it's said to have metastasized.

The most commonly used system to stage cancer is called the TNM classification.

In the TNM system, each letter stands for some aspect of the cancer:

  • T shows how much a tumor has spread inside the esophagus and nearby areas.

  • N indicates whether the lymph nodes in the area of the original tumor are cancerous.

  • M indicates whether the cancer has spread (metastasized) to other, distant organs in the body, such as the lungs, bones, or brain.

For esophageal cancer, the grade (G) is also important. The grade is a description of how the cancer cells look under the microscope. Lower grade cancers look more like normal cells and are likely to grow and spread more slowly than higher grade cancers.

 Once your T, N, M, and G categories have been determined, this information is put together in what is called stage grouping. Stage grouping is used to determine your overall disease stage. Stage grouping is shown in Roman numerals from 0 (the earliest stage) to IV (the most advanced stage). Some stages are divided further using capital letters. The stages for esophageal cancer are slightly different depending on whether the cancer is an adenocarcinoma or a squamous cell carcinoma. 

Stages of Adenocarcinoma

Stage 0 or carcinoma in situ. Cancer is found only in the inner layer of cells in the esophagus and is low grade. It has not spread outside the esophagus.

Stage IA. The cancer has grown from the inner layer of cells to the next layer in the wall of the esophagus and is low grade. It has not spread outside the esophagus.

Stage IB. The cancer has grown from the inner layer of cells to the next layer in the wall of the esophagus and is high grade. Or the cancer has grown into the muscle layer of the esophagus and is low grade. It has not spread outside the esophagus.

Stage IIA. The cancer has grown into the muscle layer of the esophagus and is high grade. It has not spread outside the esophagus.

Stage IIB. The cancer has grown through the wall of the esophagus to its outer layer (and is any grade), but it has not spread outside the esophagus. Or the cancer has has not regrown beyond the muscle layer of the esophagus, but it has spread to one or two nearby lymph nodes (and is any grade).

Stage IIIA. The cancer has has not grown beyond the muscle layer of the esophagus, but it has spread to three or six nearby lymph nodes (and is any grade). Or the cancer has grown through the wall of the esophagus to its outer layer, and it has spread to one or two nearby lymph nodes (and is any grade). Or the cancer has grown through the esophagus and has reached nearby structures, but it has not spread to lymph nodes or distant parts of the body.

Stage IIIB. The cancer has grown through the wall of the esophagus to its outer layer, and it has spread to three to six nearby lymph nodes (and is any grade).

Stage IIIC. The cancer has grown through the esophagus and has reached nearby structures, and it has spread to one to six nearby lymph nodes. Or the cancer has grown into nearby structures and can't be removed with surgery (and may or may not have reached the lymph nodes). Or the cancer has spread to seven or more nearby lymph nodes.

Stage IV. Cancer has spread to other parts of the body.

Stages of Squamous Cell Carcinoma

The location of the cancer in the esophagus affects some stages of squamous cell carcinoma.

Stage 0 or carcinoma in situ. Cancer is found only in the inner layer of cells in the esophagus and is low grade. It has not spread outside the esophagus.

Stage IA. The cancer has grown from the inner layer of cells to the next layer in the wall of the esophagus and is low grade. It has not spread outside the esophagus.

Stage IB. The cancer has grown from the inner layer of cells to the next layer in the wall of the esophagus and is high grade. Or the cancer has grown into the muscle layer of the esophagus or the outer layer, is low grade, and is only in the lower part of the esophagus. It has not spread outside the esophagus.

Stage IIA. The cancer has grown into the muscle layer of the esophagus or the outer layer, is low grade, and is in the middle or upper part of the esophagus. Or the cancer has grown into the muscle layer of the esophagus or the outer layer, is high grade, and is only in the lower part of the esophagus. It has not spread outside the esophagus.

Stage IIB. The cancer has grown into the muscle layer of the esophagus or the outer layer, is high grade, and is in the middle or upper part of the esophagus. Or the cancer has has not grown beyond the muscle layer of the esophagus, but it has spread to one or two nearby lymph nodes (and is any grade).

Stage IIIA. The cancer has has not grown beyond the muscle layer of the esophagus, but it has spread to three or six nearby lymph nodes (and is any grade). Or the cancer has grown through the wall of the esophagus to its outer layer, and it has spread to one or two nearby lymph nodes (and is any grade). Or the cancer has grown through the esophagus and has reached nearby structures, but it has not spread to lymph nodes or distant parts of the body.

Stage IIIB. The cancer has grown through the wall of the esophagus to its outer layer, and it has spread to three to six nearby lymph nodes (and is any grade).

Stage IIIC. The cancer has grown through the esophagus and has reached nearby structures, and it has spread to one to six nearby lymph nodes. Or the cancer has grown into nearby structures and can't be removed with surgery (and may or may not have reached the lymph nodes). Or the cancer has spread to seven or more nearby lymph nodes.

Stage IV. Cancer has spread to other parts of the body.

 
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