Cancer staging is a term used to refer to describing the tumor's size and whether or not it has spread beyond the area where it began.

Staging systems are constantly being updated to be able to help doctors plan the best treatment and help give them an idea of the probably outcome of treatment.

Your doctors will describe your cancer using the TNM and number staging systems.

TNM staging

This system gives precise information about the stage that the cancer is in.

T- Tumor

Describes the size of the tumor and whether it has begun to spread. A number is placed beside the T to describe the size and the extent to which it has propagated.

T1: the cancer has grown into the internal layer (mucosa or submucosa) of the esophagus.

T2: the cancer has grown into the muscle layer.

T3: the cancer has grown into the outer layer (adventitia) of the esophagus.

T4: the cancer has spread into nearby structures.

T4a: The cancer has spread to the lining of the lungs
(the pleura), the outside layer of the heart (the pericardium)
or the layer of muscle below the lungs (the diaphragm).

T4b: The cancer has spread to other nearby structures, such as
the trachea, the spine,or the blood vessels.

N- Nodes

This is a description of whether the cancer has spread to the lymph nodes. The N may have an X or a number beside it, giving additional information.

NX: The nearby lymph nodes cannot be assessed.

N0: No cancer cells in the lymph nodes.

N1 - There are cancer cells in 1-2 lymph nodes.

N2 - There are cancer cells in 3-6 lymph nodes.

N3 - There are cancer cells in 7 or more lymph nodes.

M - Metastasis
This describes whether the cancer has spread to another part of the body, such as the liver or the lungs. The M may have a number written alongside it, which gives additional information on where the cancer has spread to.

M0 - The cancer has not spread to other parts of the body.

M1 - The cancer has spread to other parts of the body. This is so-called metastatic esophageal cancer.

Numeric staging

Stage 0 - This is a very early stage of esophageal cancer.
It is sometimes called carcinoma in situ (CIS) or high-grade dysplasia (HGD). This is when there are abnormal cells present, though they are contained in the lining of the esophagus.
If this goes untreated, the cells can turn into invasive cancer. There are usually no symptoms in this stage.

Stage 1A - The cancer is found only in the internal lining of the esophagus. It has not spread to the nearby tissues, lymph nodes, or other organs.

Stage 1B - The cancer has begun to spread into the muscular layer of the esophagus, though no to the nearby lymph nodes or other organs.

Stage 2A - The cancer has grown through the outside layer of the esophagus, though not to nearly lymph nodes or other organs.

Stage 2B - The cancer is in the first two layers of the esophagus and has spread to 1-2 lymph nodes. It has not spread to other organs.

Stage 3A - The cancer may have:

- spread to the layer that lines the lungs (the pleura), the outside layer of the heart (pericardium), or the muscle layer below the lungs (the diaphragm), though not to lymph nodes or any other place. or

- grown in the external layer of the esophagus to 1-2 lymph nodes, though not to other organs. or

- spread to the first two layers of the esophagus and up to 3-6 lymph nodes, but not to other parts of the body.

Stage 3B - The cancer has spread in the outside layers of the esophagus and in 3-6 lymph nodes. It has not spread to other organs.

Stage 3C - The cancer may have:

- spread to the layer that lines the lungs (the pleura), the outside layer of the heart (pericardium), or the muscle layer below the lungs (the diaphragm), and into as many as 6 lymph nodes. or

- spread to nearby structures such as the trachea, spine, and any number of lymph nodes. or

- grown to any size and spread to 7 or more lymph nodes, though not to other organs.

Stage 4 - The cancer has spread to other parts of the body such as the liver, lungs, or stomach (metastatic cancer).