What is staging and grading?

Your cancer doctor needs certain information about the cancer to advise you on the best treatment for you. This includes the following:

  • The stage of the cancer, which describes its size and whether it has spread.
  • The grade of the cancer, which gives an idea of how quickly the cancer might grow and spread.

This information comes from the tests you have had.

Your cancer doctor and specialist nurse will talk to you about this. They will explain how it helps you and your doctor decide on your treatment plan.

Staging of ureter and renal pelvis cancer

Staging refers to how far the cancer has grown into the tissues of the ureter or renal pelvis and whether it has spread to lymph nodes or other parts of the body.

Your cancer doctor and specialist nurse will talk to you about this. They will explain how it helps you and your doctor decide on your treatment plan.

Stages may be described as a number from 0 to 4.

Stage 0

This stage is also called carcinoma in situ. The cancer is only growing on the inside of the lining (mucosa) of the renal pelvis or ureter, but not through it.

Stage 1

The cancer has spread through the inner lining (mucosa) of the renal pelvis or ureter, into the connective tissue.

Stage 2

The cancer has grown into the muscle layer of the renal pelvis or ureter.

Stage 3

  • For cancer of the renal pelvis – the cancer has grown through the muscle to the tissue or fat inside the kidney.
  • For cancer of the ureter – the cancer has grown through the muscle into the fat that surrounds the ureter.

Stage 4

The cancer has spread to one or more of the following areas:

  • the layer of fat surrounding the kidney
  • nearby organ(s)
  • one or more lymph nodes
  • distant parts of the body, such as the lung, liver, or bone.

Other terms used for cancer stages

Your doctor may use the following terms to describe the stage of the cancer:

  • Localised – the cancer is only in the area where it started and has not spread outside the kidney or ureter.
  • Regional – the cancer has spread to the tissue around the kidney or to nearby lymph nodes.
  • Metastatic (secondary) – the cancer has spread to other parts of the body.

Grading of ureter and renal pelvis cancer

Cancers of the ureter and renal pelvis are given a grade from 1 to 4. The lower the number, the lower the grade.

  • Low-grade means the cancer cells are more like normal cells. Grade 1 and 2 cancer cells are slow-growing and less likely to spread.
  • High-grade means the cancer cells are less like normal cells. Grade 3 and 4 cancer cells grow more quickly and are more likely to spread.

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