Hodgkins Lymphoma Staging
Staging is the process of determining with specific tests whether cancer has spread and, if so, how far. It is important to know the stage of the disease in order to plan treatment and this also helps to predict outcome, or prognosis.
- Stage I: cancer is only in one group of lymph nodes, or it has started in one organ and has not moved to another part of the body.
- Stage II: cancer shown in two or more groups of lymph nodes and on the same side of the diaphragm in the body; all disease is in either the upper or lower half of the body. This means that if the lymph nodes in the neck and underarms both show cancer, it is stage II. However, if the lymph nodes in the groin and neck show cancer, it is not stage II, because those two parts of the body are on different sides of the diaphragm. Cancer that is in one group of lymph nodes and extends directly into a nearby organ is also stage II.
- Stage III: cancer shown in two or more groups of lymph nodes on different sides of the diaphragm, such as the neck and groin. There might also be spread of the cancer from the lymph nodes to nearby organs.
- Stage IV: cancer has spread widely through distant organ(s) outside of the lymphatic system. Other lymph nodes in the body may or may not show signs of the cancer. Typical stage IV disease is when Hodgkin's lymphoma is found in the bone marrow or in organs (lung, stomach, liver, bone).
Additional Symptoms Used in Staging
Hodgkin's lymphoma stages are also noted by the presence or absence of certain symptoms of the disease:
- The letter "B" is added (i.e. stage IIB) is added if the person has any B symptoms (fever, night sweats, weight loss).
- If a person does not have these B symptoms, the letter "A" is added after the Roman numeral.
- If the Hodgkins disease has spread from a lymph node to a nearby organ, the letter "E" is added.
- If it involves the spleen, the letter "S" may be added.
- The letter "X" may be added if a person has bulky disease. This means a tumor in the chest is at least one-third as wide as the chest, or a tumor in another area is at least 10 centimeters (about 4 inches) across. Bulky disease may require more intensive treatment.
For example, stage IIIB is disease that is symptomatic, involves lymph node regions or structures on both sides of the body, and is further classified depending on the organs and areas involved.
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