The nearby lymph nodes are rated on a scale of 0 to 3. A score of N0 means the lymph nodes are free of cancer. N1 means that a few cancer cells have reached one or more lymph nodes. N3 means that cancer in the lymph nodes is extensive and widespread.
- NX: Nearby lymph nodes can’t be tested or evaluated
- N0: No cancer in nearby lymph nodes, or it can’t be found
- N1-3: Cancer is present in an increasing number of nearby lymph nodes
M for metastasis. An M0 cancer has not spread to other parts of the body, but an M1 cancer has.
- MX: It’s unknown if the cancer has spread
- M0: Cancer has not spread to other parts of the body, or it can’t be found anywhere else
- M1: Cancer has spread to one or more distant parts of the body
So if your cancer is rated T1 N1 M0, you’ll know your prospects look fairly good. The main tumor was small, and although a little bit of cancer was found in your lymph nodes, the disease hasn’t reached other parts of the body.
A T4 N3 M1 cancer would put a person at the opposite end of the spectrum. Even then, a patient’s future would depend on many other factors, including overall health and type of cancer.
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For many types of cancer, each TNM rating also corresponds to a simple stage from zero to four. Doctors often use this staging when talking to patients.
Stage 0 is the earliest type of cancer that has barely begun to grow. Stages I through III include cancers that may have spread to nearby tissues, organs, or lymph nodes, with I being the smallest, least extensive and III being the largest and most extensive. Stage IV (4) includes all cancers that have spread beyond the lymph nodes to more distant parts of the body. For some cancers these stages might be broken down further, and so the Roman numerals would be followed by a letter, for example stage IIIB.
Another system used in major cancer registries uses summary staging, in which cancers are described in one of five terms: “in situ” (still in the original tissue layer), localized (still in the original organ), regional (spread to nearby lymph nodes or other nearby organs), distant (spread to distant body parts), and unknown.