Staging systems are used for most types of cancer, as this gives an indication of the growth of the cancer, and how far it has spread. The stage also tells a physician what the best course of treatment is. The exact stage, however, can often not be determined until after surgery. Gallbladder cancer staging is quite complex, and three different methods are used.
The TNM system and the number systems are the most popular types of gallbladder cancer staging systems. However, you must remember that these staging systems are not meant for you, but rather for your medical team to understand what is going on with regards to the cancer. That said, you can always ask questions as to how your stage relates to the treatment that you are offered.
Different Gallbladder Cancer Staging Systems:
1. TNM Stages
TNM means Tumor, Node, Metastasis. As such:
– T is the spread and size of the tumor on the gallbladder, ranging from very early Tis (carcinoma in situ) to T1 through T4. At T2, there is T1a and T1b, with each increase towards T4 meaning that the tumor has grown larger and spread more.
– N will tell physicians whether the cancer has reached the lymph nodes. Three N stages exist and these are N0 (no effect on lymph nodes), N1 (the cancer has affected one or more nodes nearby), and N2 (the cancer is affecting more distant lymph nodes).
– M will tell physicians whether the cancer has started to affect other parts of the body. Two stages exist here: M0 indicates that there is no spread to structures away from the gallbladder; while M1indicates that the cancer has spread. Distant metastasis is when it has spread to very far removed organs.
Put together, these stages give a complete picture. For instance, a T3, N0, M0 case has a tumor that has come outside of the gallbladder, spreading to some other structure, but the lymph nodes are not affected, and the cancer remains localized.
2. Number Stages
There are four gallbladder cancer number stages, although some say five:
– Stage 0, which is carcinoma in situ or CIS. This is a very early stage and is rarely diagnosed at this point.
– Stage 1 is when the cancer affects the gallbladder's inner tissue layer, but there is no spread. This means that it would be T1, N0, M0.
– Stage 2 is when the cancer has gone through the gallbladder wall's muscle tissue and has started to spread. This would be T2, N0, M0.
– Stage 3 is divided into 3A and 3B. At 3A, the cancer has gone through the wall, but does not affect the lymph nodes. This would be T3, N0, M0. At 3B, it has spread to the lymph nodes. This would be T1, T2 or T3, and it is generally N1 and M0.
– Stage 4, which is an advanced stage that can either be 4A or 4B. At 4A, the cancer is in one of the liver vessels and in at least two other organs, as well as possibly some lymph nodes (T4, N0 or N1, M0). 4B is any size cancer that is at distant lymph nodes by hasn't spread further (Any T, N2, M0), or that has also spread to distant structures (Any T, Any N, M1).
3. The Simple Staging System
The simple staging system is usually given to patients to better understand their condition. Here:
– Stages 1 and 2 are "localized", which means the cancer hasn't spread.
– Stages 3 and 4 are "unresectable", which means it has spread and surgery cannot remove all of it.
– "Recurrent", which means you received treatment, but it came back. Some physicians refer to this as stage 4.