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Anal cancer - Staging

Staging
Once it's confirmed that you have anal cancer, your doctor works to determine the size of the cancer and whether it has spread — a process called staging. Determining your cancer's stage helps your doctor determine the best approach to treating your cancer.
Tests and procedures used in the staging of your cancer may include:
Computerized tomography (CT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
Your doctor uses the information from the procedures to assign your cancer a stage. The stages of anal cancer are:
Stage 0 anal cancer
As the earliest stage of anal cancer, stage 0 means the cancer has not grown beyond the top layer of anal tissue. It is also called carcinoma in situ or Bowen’s disease.
A stage 0 anal cancer diagnosis occurs along with the following TNM categories:
Tis: The cancer has not grown beyond the anal lining.
N0: The cancer has not spread to the lymph nodes.
M0: The cancer has not spread to organs or other nearby areas.
Stage I anal cancer
The cancer has spread beyond the top layer of anal tissue, but it has not spread to nearby lymph nodes or distant sites.
A stage I anal cancer diagnosis occurs along with the following TNM categories:
TI: The tumor is less than 2 cm.
N0: The cancer has not spread to nearby lymph nodes.
M0: The cancer has not spread to distant sites.
Stage II anal cancer
A tumor in stage II anal cancer may be classified as either T2 or T3.
A stage II anal cancer diagnosis occurs along with the following TNM categories:
T2 or T3: The tumor is greater than 2cm but has not spread to nearby organs.
N0: The cancer has not spread to nearby lymph nodes.
M0: The cancer has not spread to distant sites.
Stage III anal cancer
Stage III anal cancer is divided into two subcategories: IIIA and IIIB. The difference between the categories is the extent to which the cancer has spread.
Stage IIIA anal cancer can be staged in two different ways using the TNM scale:
T1-T3: The cancer is any size but has not grown into nearby organs.
N1: The cancer has spread to the lymph nodes around the rectum.
M0: The cancer has not spread to distant sites.
OR
T4: The cancer has spread to nearby organs, such as the vagina or bladder.
N0: The cancer has not spread to nearby lymph nodes.
M0: The cancer has not spread to distant sites.
Stage IIIB cancer can be staged in two different ways using the TNM scale:
T4: The cancer has spread to nearby organs, such as the vagina or bladder.
N1: The cancer has spread to the lymph nodes around the rectum.
M0: The cancer has not spread to distant sites.
OR
T1-T4: The cancer is any size and may or may not have grown into nearby organs.
N2-N3: The cancer has spread to the lymph nodes in the groin or pelvis, and may or may not have spread to lymph nodes around the rectum.
M0: The cancer has not spread to distant sites.
Stage IV anal cancer

Stage IV is the most advanced stage of anal cancer. The cancer is any size, and may or may not spread to nearby organs, such as the vagina or bladder (any T). The cancer may or may not have spread to nearby lymph nodes (any N). A diagnosis of stage IV anal cancer means that the cancer has spread to distant organs and tissues (M1).

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