By The Numbers

Kevin is resting after his second walk of the day.

We received the pathology report in the mail.

Cancer staging takes a lot of things into account and varies from cancer to cancer. Most commonly, Roman numerals of I, II, III and IV as well as TMN Staging. In solid tumors like Kevin's, both are used.

Kevin's tumor has been rated as T3 N0 Mx on the pathology report.

The TNM staging refers to Tumor, Nodes and Metastasis.

Tumor ranking is 0 - 4 and indicates the extent of the tumor. How far it has invaded. A T0 tumor has not invaded into local tissue, a T4 has grown into nearby organs. Obviously, the lower the T ranking, the better. Kevin's tumor is on the low end of being a T3. There is no visible invasion outside of the bowel wall until it is examined microscopically. Then it shows on the outer surface of the bowel. It has not invaded into other tissue of organs.

Nodes refers to lymph nodes which can help cancer cells to spread throughout the body. You want a low number here too. N0 means no biopsied lymph nodes showed involvement. N4 would mean extensive involvement including number, size and location. Kevin's biopsy shows no lymph node involvment in the lymph nodes that were examined. This is good news.

Metastasis is usually either 0 or 4. M0 means there is nothing to indicate the cancer has spread to other parts of the body. M4 means there is spread. Kevin's official report is Mx which means the pathologist hadn't seen the CT results to support there is no metastasis so he couldn't comment on it. Now that we know the CT results, his Mx is actually an M0.

Criteria for cancer staging varies for different types of cancer. For Kevin's cancer, this adds up to a Stage II cancer. If you take the stage grading further out to something called AJCC ranking, it adds up to a Stage II A cancer which is even better.

Additionally they look at something called the grade of tumor. Kevin's falls into the middle of the range being "moderately well differentiated."

So the negatives are that it is a large tumor which has invaded through the bowel wall. This increases the liklihood that it might have spread already. And it is only "moderately well differentiated."

The positives are that is it "moderately well differentiated" instead of "poorly." It hasn't invaded other tissues or organs. There are no lymph nodes involved and no obvious metastasis.

So it could be better. We would have liked a nice T2. But it could be a lot worse so we'll take these numbers with thankfulness.