60RRBH25R0009 CMOS Example of PowerPoint Training Attachment 7.pdf

13.00 Cancer

Prepared for U.S. RRB

Disability Claims Examiners

November 2023

General Cancer Terms

Carcinoma and Carcinoid are not the same thing.

Carcinoma is a cancerous tumor that develops within the epithelium (or lining layer) of one of the body's many cavities or organs1.

Carcinoid is a tumor that resembles a carcinoma, but is usually benign. However, some carcinoid tumors are malignant and can be considered a type of carcinoma.

The TNM Staging System

The TNM system is the most widely used cancer staging system.

You are likely to see your cancer described by this staging system in your pathology report unless there is a different staging system for your type of cancer.

Examples of cancers with different staging systems include brain and spinal cord tumors and blood cancers.

Look for this: It will be in every Oncologist’s Note

In the TNM system •The T refers to the size and extent of the main tumor.

The main tumor is usually called the primary tumor.

•The N refers to the number of nearby lymph Nodes that have cancer.

•The M refers to whether the cancer has metastasized.

This means that the cancer has spread from the primary tumor to other parts of the body.

When your cancer is described by the TNM system, there will be numbers after each letter that give more details about the cancer—

For example, T1N0MX or T3N1M0.

Primary tumor (T)

•TX: Main tumor cannot be measured.

•T0: Main tumor cannot be found.

•T1, T2, T3, T4: Refers to the size and/or extent of the main tumor.

• The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T's may be further divided to provide more detail, such as T3a and T3b.

Regional lymph nodes (N)

•NX: Cancer in nearby lymph nodes cannot be measured.

•N0: There is no cancer in nearby lymph nodes.

•N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer.

•The higher the number after the N, the more lymph nodes that contain cancer.

Distant Metastasis (M)

•MX: Metastasis cannot be measured.

•M0: Cancer has not spread to other parts of the body.

•M1: Cancer has spread to other parts of the body.

•In situ—Abnormal cells are present but have not spread to nearby tissue.

•Localized—Cancer is limited to the place where it started, with no sign that it has spread.

•Regional (Mets)—Cancer has spread to nearby lymph nodes, tissues, or organs.

•Distant (Mets)—Cancer has spread to distant parts of the body.

•Unknown—There is not enough information to figure out the stage.

Other Terminology Used:

What it meansStage

Abnormal cells are present but have not spread to nearby tissue. Also called carcinoma in situ, or CIS. CIS is not cancer, but it may become cancer.

Stage 0

Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.

Stage I, Stage II, and Stage III (may also be written as Stage 1, Stage 2, and Stage 3)

The cancer has spread to distant parts of the body.Stage IV (may also be written as Stage 4)

The TNM system helps describe cancer in great detail. But for many cancers, the TNM combinations are grouped into five less-detailed stages.

The higher the number, the more advanced the cancer is. Letters and numbers are often used after the first number to describe the cancer in more detail.

For instance, Stage 2 prostate cancer may be further divided into 2A, 2B, or 2C.

Common Tests Used to Stage Cancer

Pathology: (From Biopsy or Pathology report from Surgery)

Will have tissue/cell type: “It is not cancer until it is under the microscope”

-Small Cell, Large Cell, Oat Cell”

- Adeno, Basal Cell, Squamous Cell

- Hepatocellular (liver) renal Cell (Kidney) Cholangiocarcinoma (Bile Duct)

Radiology: CT MRI PET Scan

Lab Tests: to Follow Disease Remission/Progression Ex: PSA CEA CA-125

‘p’ is for Pathologic Stage pT4a