© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer's stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancer.
After the diagnostic tests (described in the Diagnosis section) are completed, the doctor will assign a stage, which is needed to plan treatment. The four stages of Hodgkin lymphoma (I to IV; one to four) are described below.
In addition, each person’s disease is put into one of two categories, A or B, based on whether the person has symptoms of unexplained fever, drenching night sweats, or weight loss in the six months before diagnosis. A means the patient does not have these symptoms, while B means that the patient has at least one of these symptoms.
Stage I: Cancer is in only one area of the lymph nodes or in one area or organ outside of the lymph nodes.
Stage II: Cancer is in two or more lymph node areas on the same side of the diaphragm, or cancer is in one lymph node area and in one area or organ next to the lymph nodes.
Stage III: Cancer is in lymph node areas above and below the diaphragm. The cancer may have spread to an area or organ near these lymph nodes and, possibly, to the spleen.
Stage IV: Cancer has spread outside of the lymph node system to the lungs, liver, bones, bone marrow, or other organs.
Recurrent: Recurrent cancer is cancer that comes back after treatment. If there is a recurrence, the cancer may need to be staged again (re-staging) using the system above.
A treatment regimen (schedule) may be selected based on the disease’s classification as low, intermediate, or high risk. This classification is based on several factors, including the cancer’s stage, whether the tumor is bulky, and whether the patient is experiencing specific symptoms (defined as A or B; see above).
- Children with low risk Hodgkin lymphoma usually have stage IA or stage IIA disease without bulky tumors.
- In high risk Hodgkin lymphoma, the cancer is in a later stage or is causing B symptoms like fever, drenching night sweats or weight loss. This could include stages IIIB and IVB.
- Other patients are usually considered intermediate risk.
Source: The Ann Arbor staging system, as outlined by and used with permission from the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010), published by Springer-Verlag New York, www.cancerstaging.net.