Bone Cancer Staging
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Staging Bone Cancer
Once bone cancer has been confirmed through a biopsy or imaging tests, the staging process provides information about the spread and extent of the cancer. The process of removing a sample of the cancerous bone tissue (a biopsy) may produce results that influence your treatment options. Talk with an orthopedic surgeon familiar with malignant bone tumors about how a particular biopsy procedure may affect the possibilities for limb-sparing surgery.
The American Joint Commission on Cancer (AJCC) TNM system is commonly used to stage bone cancer. This system is defined by three key components: tumors, lymph nodes, and metastasis (spread).
Each category (T, N and M) is assessed and rated. And G denotes grade of tumor (i.e., the rate the tumor is likely to grow and spread based on the abnormality of the cancerous cells). For treatment purposes, bone cancer is usually referred to as either Low Grade (G1-G2) or High Grade (G3-G4).
Understanding the TNM System
- T is rated on a scale 0-3 where T0 indicates no evidence of the primary tumor expanding into local tissue, and the increasing numbers (T1-T3) correspond to the increasing size/extent of the tumor.
- N is an evaluation of the involvement of regional lymph nodes. This is rated as either N1 (evidence of regional lymph node involvement) or N0 (regional lymph nodes are cancer free).
- M, metastases, is labeled as either M0 (no sign of metastases) or M1 (the cancer has spread). If the cancer has metastasized, it may be further described as M1a (the cancer has spread only to the lung) or M1b (the cancer has spread to other sites)
Note: Sometimes An X is used to denote insufficient information; that is, the condition of the particular factor can not be adequately assessed.
Stage Grouping for Bone Cancer
The T, N and M ratings are combined in the process of stage grouping and expressed as Roman numerals, 0-IV. According the American Cancer Society, the stage groupings for bone cancer are as follows:
- Stage I Bone Cancer: At this stage, bone cancer is limited to the bone and there is no evidence of spread to other areas of the body. A low grade bone cancer, therefore, is not considered aggressive.
- Stage IA: The tumor is less than 8 cm. (T1, N0, M0, G1-G2).
- Stage IB: The tumor is larger than 8 cm. (T2, N0, M0, G1-G2).
- Stage II Bone Cancer: Like Stage I, the cancer is limited to the bone and there is no evidence of spread to other areas of the body. However, the biopsy testing reveals that the bone cancer is high grade and has the potential to grow and spread quickly (aggressive).
- Stage IIA: The tumor is less than 8 cm. (T1, N0, M0, G3-G4).
- Stage IIB: The tumor is larger than 8 cm. (T2, N0, M0, G3-G4).
- Stage III Bone Cancer: The cancer has not spread outside of the bone, but it occurs in two or more places on the same bone. It may be any grade. (T3, N0, M0, G1-G4)
- Stage IV Bone Cancer: The cancer has spread beyond the bone to other areas of the body, such as the brain, liver or lungs. They can be any grade.
- Stage IVA: The tumor has spread to the lung. (Any T, N0, M1a, G1-G4)
- Stage IVB: The tumor has spread to nearby lymph nodes or other sites beyond the lung (but may include the lung). (Any T, N1, any M, G1-G4 OR Any T, any N, M1b, G1-G4.
For treatment purposes, your oncologist may simply refer to the stages as localized (stages I-III) or metastatic (stage IV).
Treatment Possibilities for Bone Cancer at CTCA
At Cancer Treatment Centers of America (CTCA), we believe in patient-centered bone cancer treatment. That is why treatment at CTCA is guided by your preferences and needs.
When you're ready to learn more, call 800-615-3055 or Chat Now to talk with one of our Oncology Information Specialists. Our representatives are available 24 hours a day, every day of the week. We're ready to help, at any stage.
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