Cancers come in many different types and progress through several stages as they grow. To begin to treat your cancer, we must first determine what type of cancer it is and at what stage in its growth it is in. This is your individual diagnosis.

• Testing
• Determining the Cancer's Stage
• Determining the Prognosis
• You and Your Cancer Care Team

Testing

Diagnosis begins with testing. We may use advanced diagnostic imaging methods such as ultrasound or Magnetic Resonance Imaging (MRI) scans to let us "look" inside your body to see the size and shape of the cancer and where it is located. Samples of the cancer and the surrounding tissue will also be studied under a microscope by a pathologist. When examining the tissue samples, the pathologist will ask:

• How abnormal are the cancer cells? Some cancer cells still have many of the features of normal cells, while others have few features of normal cells. The pathologist will give the cancer cells a numerical grade to indicate how much they look like their normal counterparts. The higher the number, the more abnormal the cancer cells.
  
• Have the cancer cells spread into surrounding tissue? The pathologist will measure the distance between the cancer and the edge of normal tissue.
  
• What is the pattern of growth of the cancer cells?

Departments you may work with during the diagnostic testing include:

• Laboratory
  
• Nuclear Medicine
  
• Pathology
  
• Radiology

You have a right to see the results of all of these tests, and PAMF's electronic health record system makes this easier than ever before. If you have not already done so, consider signing up for PAMFOnline, our secure personal health record. Through PAMFOnline, you can view your test results, request appointments and prescription renewals, and much more.

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Determining the Cancer's Stage

After your health care providers know what type of cancer you have, they will determine what "stage" the cancer is at. This means how far advanced in its growth it is. There are many staging systems, but a common example is the TNM. The "T" refers to the size of the tumor, the "N" to the number of lymph nodes involved and the "M" to metastases (the spread of the cancer to other organs through the lymphatic and/or circulatory system). Generally, the lower the stage, the less advanced the cancer is and the better the treatment outcome is likely to be.

• Stage 0 = precancer
  
• Stage 1 = small cancer found only in the organ where it started
  
• Stage 2 = larger cancer that may or may not have spread to the lymph nodes
  
• Stage 3 = larger cancer that is also in the lymph nodes
  
• Stage 4 = cancer in a different organ from where it started

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Determining the Prognosis

After your cancer care team knows what type of cancer you have and how advanced that cancer is, the team will look at your general health to determine what the most likely outcome of your cancer will be. This "prognosis" will help you and your cancer care team plan your treatment. Some of the factors that help determine your prognosis include:

• Your age
  
• Your level of physical fitness
  
• The size of your cancer
  
• The stage of your cancer
  
• The aggressiveness of your cancer (how rapidly the cancer is growing)

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You and Your Cancer Care Team

We are committed to partnering with you in your care from the time of diagnosis through your treatment and beyond. Our cancer health care providers work together to provide you with comprehensive, integrated care.
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