Stages

[ellakc2]

Hi everyone! I have a question! I always see EX: IIB or IIIA . My Dr. never put a letter A or B behind my class. I asked this question once before and Cindy got back to me and said A is operable and B is non-operable. After she told me this I heard soooo many conflicting answers.

Does anyone definiately know??? I have never see it anywhere in print.

And I don't go to see my Dr. until December. Extremely curious???

[Don Wood]

As I understand it, A and B are just subdivisions of each stage category that the docs use to choose protocols. A is closer in to the original site than B. I don't think it is particularly helpful to us non-med types. Don

[Nancy B]

Not sure if this will help, but 4 years ago I was told I was IB because my tumor was 6 cm, if it had been under 3 cm it would have been 1A - there was no lymph node involvement so it was Stage I.

Take care,

Nancy B

[Andrea]

There are lots of websites which explain, but as Don said, i think it means whether the tumor and/or lymph node involvement is further away.

Typically, and of course it varies depending on the person, Stages IA&B, IIa&B, and IIIA are able to have surgery.

[carrie]

I was diagnosed as nsclc stage IIIB and they were able to do surgery so I don't know if that is the case.

Carrie

[john]

The first link describes everything. A and B are subdivisons of the stage.

B is "more advanced" than B. Just like what Don said

http://www.cancerhelp.org.uk/help/default.asp?page=6741

http://www.oncologychannel.com/lungcanc ... ages.shtml

I believe, in general IIIB is not a candidate for surgery, except in a few cases.

The cases area: on staging the patient the PET scans and other tests did not detect the lymph node involvement. The other case would be where neoadjuvant chemo and/or radiation (chemo and/or radiation before surgery) "downstages" the patient to where resection may benefit the patient.

I would guess you had a large tumor T4 and little lymph node involvement, you had a very good response to chemo and that is why they did the surgery

The lymph nodes below the heart are considered less advanced than ones around the clavicle. If lymph nodes are involved on the opposite side of the tumor this is also considered "worse".

[BoBennett]

I’ve been trying to figure out the staging myself and its my conclusion that there is no default set of rules with the exception of; I, II, IIIa, IIIb, IV, at least those are ones I run across in the major organizations and they seem to be accepted within most organizations. As already mentioned the size and distance of mets and their locations aid in the staging and I think some groups just add classes after viewing the variables for their use. I think to, obviously A is closer to the lower number than B, better and worst I would guess. These kind of questions are good. When I began learning about cancer I am surprised daily at the different sets of rules that explain such things. Who would a thunk that in this day everyone would have not been on the same page.

Bo

[ellakc2]

Hey Bo,

What's the difference between IIIA and IIIB?

[stand4hope]

If you have stage 3A lung cancer, you could have any of these TNM stages:

T1, N2, M0

T 2, N2, M0

T3, N1, M0

T3, N2, M0

If you have stage 3B lung cancer, you could have either of these TNM stages:

Any T, N3, M0

T4, any N, M0

Tumors (T)

The T stages for lung cancer are:

T1 - the tumor is 3cm or less across

T2 - the tumor is more than 3cm across or involves the largest airway (the main bronchus) or the tumor has caused a partial collapse of that lung or the tumor has grown into the inner lining of the chest cavity (the visceral pleura)

T3 - the tumor has grown into the chest wall, the outer lining of the chest cavity (the mediastinal pleura), the muscle at the bottom of the chest cavity (the diaphragm) or the outer covering of the heart (the pericardium) or the tumor has caused the whole lung to collapse

T4 - the tumor has grown into the area between the lungs in the middle of the chest (the mediastinum) or there is fluid around the lung that contains cancer cells (a malignant pleural effusion)

Nodes (N)

The N stages for lung cancer are:

N0 - there is no cancer in any lymph nodes

N1 - there is cancer in the lymph nodes nearest the affected lung

N2 - there is cancer in lymph nodes in the centre of the chest (mediastinum) but on the same side as the affected lung or there is cancer in lymph nodes that lie just under where the windpipe branches off to each lung

N3 - there is cancer in lymph nodes on the opposite side of the chest from the affected lung or in the lymph nodes above either collar bone

Metastases (M)

The M stages for lung cancer are:

M0 - there are no signs of cancer spread to another lobe of the lung or any other part of the body

M1 - there is cancer spread to another lobe of the lung or any another part of the body

[BoBennett]

The explanation stand4hope put up is what I believe to be the clinically acceptable criteria for staging, however, my take is that IIIb is looked at as miles away from IIIa in severity. In my travels I have found that even though this is what the majors use as criteria, doctors often seem to use other variables for bypassing the criteria as there are so many variables that come into account that staging should not be looked at as an ultimate diagnosis.

Keep on searching info, it helps in our control of what is happening. If I were your doctor I would knock off 2 stages just because you stopped smoking.

Good luck in your fight.

Bo

[stand4hope]

Performance Status is something else that I think is helpful in understanding different stages and how they affect different people. Also, I have seen articles that say that Stage IV should be re-classified and broken down further. Performance status also plays a big part in survival. The link below has the three ways that cancer patients are classified in regard to performance.

My husband is at the top, or very close, on all three charts, which explains at least one of the reasons why he is doing so well in spite of the extent of his disease. On the flip side, these charts could be a "downer" for some of you that aren't feeling well, so please don't read anything into them that isn't there. I hesitated to post these charts for that reason, but I decided to go ahead since most of us want to know these things and they can be very encouraging for a lot of you. Here's the link:

http://www.fda.gov/cder/cancer/perstatframe.htm

Love to all,

Peggy