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Curious about staging & grading system? Curious about staging & grading system?

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Unread 02-02-2006, 12:00 AM
Curious about staging & grading system?

I'm just curious about the staging & grading system for cancer. Why are there letters as well as numbers? For example my final staging was 1b, grade 2 but I really don't know what this means exactly? I was told I needed no furthter treatment, but I would like to understand more & especially being upgraded from a grade 1 pre-op to a grade 2 pot-op.
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Unread 02-02-2006, 12:24 AM
Curious about staging & grading system?

Mori, it's easier if you Google "grading and staging of endometrial cancer". It's explained step by step. Wish I had a specific link to give you, but you will find it through Google.

Grade refers to the type of cells in the cancer, and how aggressive they are. A grade 1 is the best to have. A grade 3, not the best. It kind of predicts how the cancer cells will act if they spread. Grade 3 is harder to treat, more aggressive.
Unread 02-02-2006, 05:31 AM
Here is one link

Hi Mori,

Here is one link for the NCI info on endometrial cancer staging.
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Unread 02-02-2006, 07:31 AM
Curious about staging & grading system?

Thanks so much for the info & the link. Does having grade 2 staging increase chances of a recurrence? I think I'm in cancerhead mode today.
Unread 02-02-2006, 08:49 AM
Curious about staging & grading system?

Hi Mori
I was also concerned when it turned out I had Gr. 2 after the staging.
The encologist and my gyno has told me that because the cancer is encapulated when caught early, it makes little difference in outcomes.
I know what you are feeling. It has gotten a bit better for me but going for my three month checkup brought back a lot of the old feelings.
I'm going to be followed for five years through a clinic directed by Cancercare Manitoba. . It has had a 97% survival rate over 5 years which sounds pretty good as this factures in more severe cases than mine.
I know I will always have a little lurking fear. I am eating much more healthy and exercising more. I read a few studies that show daily exercise makes a big difference.
Once I get rid of my extra lbs I will feel a whole lot safer. That was one suggestion at my 3 month checkup that I knew would be brought up.
Hope you are recovering well. Take care, Trisha
Unread 02-02-2006, 08:49 AM
Curious about staging & grading system?

Hi there Mori!

I'll be interested to hear some opinions on this. Although my tumour was relatively small, the cells were Grade 3, and that worries me a LOT.
Unread 02-02-2006, 03:42 PM
Curious about staging & grading system?

Thanks sparrowsong for easing my mind a little. So in other wards whether it's a grade 1 or 2 makes little difference if caught early & contained in the uterus. Does the letter following the number make a difference in the stage ex: 1b? How did your 3 month appointment go? What exactly did the doctor do & check? DId you have an internal exam & pap test? Was it painful? Did you have blood tests as well? Just want to know what to expect because mine is coming up in March. Are you taking any HRT? How does losing weight post-op help? I'm sorry for posing so many questions. Finally what exactly do they mean by "five year survival rate"? I'm almost afraid to ask.
Unread 02-02-2006, 06:30 PM
My opinion...

Originally Posted by mori
So in other wards whether it's a grade 1 or 2 makes little difference if caught early & contained in the uterus.
....Does the letter following the number make a difference in the stage ex: 1b?
....How does losing weight post-op help?
....Finally what exactly do they mean by "five year survival rate"? I'm almost afraid to ask.
This is my understanding of the items you've asked. Remember to ask your doctor(s) the same questions so he/she can give you answers that specifically relate to you. Also, I'm a relative "newby" with this cancer-thing.

I've spent the better part of the past few days and other days over the past three months researching on the internet. My conclusion: There is no one answer when it comes to cancer. (If there were, it would be cured by now.)

The way grade two and grade three differences were explained to me by my doctors: grade two is a medium (speed) growing cancer and grade three is an aggressively growing. (I got bumped from a 2 to a 3.)

I was leaning toward maybe I should do chemo until I talked with one of America's top uterine cancer specialists. I was told that research shows only about a four month length in survival time by using chemo IF there is still cancer not killed by radiation. To me an extra four months isn't worth the chemo risks especially when I MIGHT be a cancer survivor without it.

I'm not sure if you have seen this link:
on staging from the ASC. I know someone gave you a link but I've looked at so many web pages since I read this thread earlier today they sort of run together.

Farther down on the above link, it explains the five year survival rate.

My onc-rad doesn't like using statistics because he has seen people he thought would make it die and people he thought were terminal survive and recover.

Re: differences in letters... If you notice the cancer is a bit farther out in the "b" ranking than the "c" ranking in each stage. It took me several looks at this to understand the differences but think of a little blob in 1a and then it grows a bit bigger in 1b and invades a bit more in the 1C stage. Same goes for the other stages, each letter describes a cancer that is a little further advanced.

So, the letter after the number tells how much or where the cancer has invaded. I'm still trying to grasp how it can spread to lymph node and not be anywhere else outside the uterus (as in the abdominal cavity) but that is the difference between 3a and 3c.

There is an interesting article published in Dec. 2005 entitled "Postoop Radiation Extends Survival in Endometrial Cancer" that you can find online if you do a websearch using the title.

Losing weight: That's my goal even though one of my doctors described me as a "thin" lady. I'd lost 10-15 lbs before he saw me over a couple of year's time but I've lost another 15 since surgery. I'd like to lose another 10-15 lbs.
Everything I've read says EXERCISE DOES help people not get cancer - at least certain types like breast and gyno cancers.
Exercise for me is easier said than done. One good thing about menopause is it helps the butt go down...

Unread 02-02-2006, 08:09 PM
Curious about staging & grading system?

Hi Mori
In answer to your question about grade 1, 2, & 3. I have had three doctors (my family dr., my gyn., and the oncologist tell me that if the cancer has not deeply invaded the wall, Grade 1 or 2 make little difference. Now if the cancer had spread through the wall of the womb, it would be a different thing altogether as a grade 2 may act more aggressively.
With stage lB, your cancer is still very early and a hysterectomy was most likely your cure.
I have read studies that show if you exercise 30 minutes a day, your chances of a relapse are lower. They think it may be because regular exercise reduces estrogen in the body. If you have some extra weight (like I do) the fat does make estrogen. The oncologist told me that this does not necessarily put me in a higher risk for re-occurance but it does put me at a higher risk for breast cancer and a host of other diseases. .
At my three month checkup, I was asked a lot of questions and encouraged to ask them.They weighed and measured me. The dr. wanted to know what warnings I had for this cancer, if there was pain, etc. He also advised me that some soy is probably safe but I should use it moderately. He asked about any changes in bowel habits, etc.
He said a well balanced diet is important with lots of fruits and veggies.
Then I had the physical exam. I got a very thorough breast exam. I put my hands behind my neck and he felt for enlarged nodes in the arm pits. Then he felt the breasts very firmly (much more than I have had at a physical ).
I was told to make an appt for a mamogram. (Something I've always avoided)
He took my blood pressure, and listened to my lungs and heart. He kneaded my abdomen. He felt for enlarged lymph nodes along the bikini line.
Then he examined me inside, said that I had healed well, and then took a pap test. He said the vaginal cuff was very smooth and well healed.
Then he felt digitally inside my rectum and said that they can feel changes in the vagina that way.
There was no blood or xrays taken though I understand I am to have a yearly chest xray. My initial CA125 was low so this won't be a marker for me.
I was past menopause Mori, so HRT was not an issue with me although I have been having a few hot flashes now and then. He seemed to think I will do fine without ovaries.
If you are younger, this may be more of a concern for you.
I know some people do take HRT after this surgery and it's something to ask your Dr. about.
By exercising, I feel empowered and stronger. It seems to diminish my anxiety. I have bought a warm down jacket and am walking everyday.
Hope I remembered everything. Hope your exam goes smoothly. I'm sure it will. All the best, Trisha
Unread 02-02-2006, 08:26 PM
Curious about staging & grading system?

Hi Mori,
It's me again.
I suppose it means that 97% of the patients are alive after 5 years and 3 out of 100 were not as fortunate. These numbers will include people who were very far advanced in their disease.
My neighbor finished her 5 years a year ago and now only goes for a yearly exam with her own physician.
Apparently the first two years are the most crucial. If somethings going to happen, most times it is within that time frame.
It might make you feel better to know that many medical experts think the chances of a relapse with early stage endo cancer is so rare it isn't worth while tracking the patients. It's easy for them to say. It isn't their lives!!
Nothing about the 3 month exam hurt except the anxiety of thinking about this whole thing.
Sincerely, Trisha

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