Stages

If gastric cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

The Spreading of Cancer

There are three ways that cancer spreads in the body:

Through tissue.
Cancer invades the surrounding normal tissue.

Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.

Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary tumor and travel through the lymph or blood to other places in the body, another, or secondary tumor, may form. This process is called metastasis. The secondary, or metastatic, tumor is the same type of cancer as the primary tumor. For example, if stomach cancer spreads to the bones, the cancer cells in the bones are actually stomach cancer cells. The disease is metastatic stomach cancer, not bone cancer.

Stages of Gastric Cancer

Stage 0 (Carcinoma in Situ): The cancer is found only in the inner layer of the stomach. It is carcinoma in situ.

Stage I is one of the following:

The tumor has invaded only the submucosa. (The picture in section 2 shows the layers of the stomach.) Cancer cells may be found in up to 6 lymph nodes.

Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have not spread to lymph nodes or other organs.

Stage II is one of the following:

The tumor has invaded only the submucosa. Cancer cells have spread to 7 to 15 lymph nodes.

Or, the tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 1 to 6 lymph nodes.

Or, the tumor has penetrated the outer layer of the stomach. Cancer cells have not spread to lymph nodes or other organs.

Stage III is one of the following:

The tumor has invaded the muscle layer or subserosa. Cancer cells have spread to 7 to 15 lymph nodes.

Or, the tumor has penetrated the outer layer. Cancer cells have spread to 1 to 15 lymph nodes.

Or, the tumor has invaded nearby organs, such as the liver or spleen. Cancer cells have not spread to lymph nodes or to distant organs.

Stage IV is one of the following:

Cancer cells have spread to more than 15 lymph nodes.

Or, the tumor has invaded nearby organs and at least 1 lymph node.

Or, cancer cells have spread to distant organs.

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