Stages

If Merkel Cell 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. Also, the doctor will perform more tests to identify if the cancer has spread to other areas of the body. Such tests may include imaging tests -- CT scan, magnetic resonance imaging (MRI), bone scan, or x-ray.

Stages of Merkel Cell Carcinoma

Stage 0 (carcinoma in situ) - In stage 0, the tumor is a group of abnormal cells that remain in the place where they first formed and have not spread. These abnormal cells may become cancer and spread to lymph nodes or distant parts of the body.

Stage I is divided into Stage IA and Stage IB:

Stage IA - In stage IA, the tumor is two centimeters or smaller at its widest point and no cancer is found when the lymph nodes are checked under a microscope.

Stage IB - In stage IB, the tumor is two centimeters or smaller at its widest point and no swollen lymph nodes are found by a physical exam or imaging tests.

Stage II is divided into Stage IIA, Stage IIB and Stage IIC:

Stage IIA - In stage IIA, the tumor is larger than two centimeters and no cancer is found when the lymph nodes are checked under a microscope.

Stage IIB - In stage IIB, the tumor is larger than two centimeters and no swollen lymph nodes are found by a physical exam or imaging tests.

Stage IIC - In stage IIC, the tumor may be any size and has spread to nearby bone, muscle, connective tissue, or cartilage. It has not spread to lymph nodes or distant parts of the body.

Stage III is divided into Stage IIIA and Stage IIIB:

Stage IIIA - In stage IIIA, the tumor may be any size and may have spread to nearby bone, muscle, connective tissue, or cartilage. Cancer is found in the lymph nodes when they are checked under a microscope.

Stage IIIB - In stage IIIB, the tumor may be any size and may have spread to nearby bone, muscle, connective tissue, or cartilage. Cancer has spread to the lymph nodes near the tumor and is found by a physical exam or imaging test. The lymph nodes are removed and cancer is found in the lymph nodes when they are checked under a microscope. There may also be a second tumor, which is either:

Between the primary tumor and nearby lymph nodes
or
Farther away from the center of the body than the primary tumor

Stage IV - In stage IV, the tumor may be any size and has spread to distant parts of the body, such as the liver, lung, bone, or brain.

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