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Esophageal Cancer: Stages

Esophageal Cancer: Stages

What does stage of cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

What are the stages of esophageal cancer?

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

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

  • T shows how much the main tumor has grown inside the esophagus and into nearby areas.

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

  • M says whether the cancer has spread (metastasized) to other, distant organs in the body. These include 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. They are likely to grow and spread more slowly than higher grade cancers.

The information of your T, N, M, and G categories is put together. This is called stage grouping. Stage grouping is used to figure out your 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 if the cancer is an adenocarcinoma or a squamous cell carcinoma. 

Stages of esophageal 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 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 not grown past 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. It has also 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. It has also 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 esophageal 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 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 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. It has also 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. It has also 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.

Talking with your healthcare provider

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure your ask questions or talk about your concerns.


 

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