Cancer staging and grading

After you have been diagnosed, your cancer doctor may do further tests to learn more about the cancer. This usually includes tests to find out the stage and the grade of the cancer:

• The stage of a cancer describes its size and whether it has spread from where it started.
• The grade of a cancer describes how abnormal the cancer cells are, compared to healthy cells. This can help your cancer doctor understand how quickly the cancer may grow, or how likely it is to spread.

Information about the stage and grade helps doctors plan the treatment you might need.

Each cancer type has its own staging system. This usually uses numbers from 1 to 4 and sometimes letters to describe the cancer’s size and spread. But staging can be complicated. Some cancer types have a specific system that is only used for that type of cancer.

Your cancer doctor or specialist nurse can explain more about the staging system they use. You can also find more about staging in our information about each type of cancer.

For some cancer types, stage is described using the number system.

There are usually 3 or 4 number stages for each cancer type. Stage 1 describes an early cancer that has not spread anywhere else in the body. Stage 4 cancer describes a cancer that has spread to other parts of the body. This is also called advanced or metastatic cancer.

The TNM staging system is used to describe many cancer types. TNM stands for tumour, node and metastases.

• T describes the size of the tumour. Sometimes it also describes the exact area of the body affected by the tumour. This is usually a number between 1 and 4. T1 is a small cancer. T4 is a larger or more advanced cancer.
• N describes whether the cancer has spread to the lymph nodes. The number can be between 0 and 3. N0 means there are no cancer cells in the lymph nodes. N3 means more lymph nodes are affected by cancer.
• M describes whether the cancer has spread to another part of the body (known as metastatic or secondary cancer). The number is either 0 or 1. M0 means the cancer has not spread to other parts of the body. M1 means it has spread.

Your doctor may use other words to describe some cancer stages:

• carcinoma in situ
• localised
• locally advanced
• advanced
• metastatic or secondary cancer.

These words can mean different things depending on the type of cancer. If your cancer doctor uses any of these words, ask them to explain what they mean.

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

• use plain English
• explain medical words
• use short sentences
• use illustrations to explain text
• structure the information clearly
• make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.