How do doctors determine what stage cancer is in and how long a patient has to live?
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Staging varies between different cancers but they are all roughly the same.
Stage 1 will always be small and no spread from original site
Stage 4 will that it doesn’t matter what size the original tumour is. There is spread to distant sites, such as lung, liver, brain, bone, etc
The stages that vary more between the types of cancers is definition of stage 2 and 3
Stage two will either be just a larger version of stage 1. Or will be that the closest lymph nodes are involved (lymph nodes drain fluid from tissues)
Stage 3 will be that the lymph nodes are involved, possibly involving some that are a bit more distant to the original tumour than are included in stage 2. It’s likely to include rumours that have invaded other tissues next to the original tissues (e.g in a breast cancer, if the tumour has invaded into the skin or chest wall will be a stage 3 regardless of if lymph nodes have cancer in them)
As for predicting how long a patient has left, it is partly to do with this number as well as other factors. It is only a prediction, so you’ll get those who live longer or shorter than the prediction
Again like the staging system, it varies between cancers but the other things that impact the prediction will be things like how the individual cells under the microscope look (rather than where the cells are, it’s how they look. And it’s called the grade of the tumour), some genetic markers, some receptors that can be found on the cells. There will also be factors about the patient too. If they are otherwise fit and well, they will likely live longer without treatment than someone with other health problems. Likewise the health of a patient will also impact on what treatment they can get. An example is that there are some chemotherapies that can adversely affect the heart, so if someone already has heart problems, these won’t be an option for treatment, even if the tumour would respond very well to it, because it would injury/kill the patient.
All these things are put together and compared those with similar rumours to give predictions. It might be the chance of the person surviving a certain length of time with treatment (5 years is often the time used). Or for cancers that don’t have a chance of cure, then the prediction would be related to how long the person has to live. This will likely be without any treatment aimed at prolonging life, and with palliative treatment such as chemotherapy to give more time. In these situations in adults, they may choose to undergo treatment knowing that it will come with side effects but probably give more time, or decide that those effects aren’t worth the extra time for them
I hope this has made sense. Happy to clarify if any of it is unclear
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