What is staging and grading in cancer? What are the differences?

In this blog, Hilary, Cancer Information Development Nurse, answers some of your questions about staging and grading in cancer. 

What does grade mean in cancer?

Getting a cancer diagnosis can feel a bit like learning a new language. In this post, we answer some questions about grading. A cancer grade is one of the factors your cancer team might consider when they plan treatment.

Is grade the same as stage in cancer?

Cancer grading and cancer staging are two different things.

Stage describes how a cancer has developed or spread. For example:  

• what size a tumour is
• what areas of the body are affected by cancer
• whether cancer has spread from where it started.

Grade looks at the actual cancer cells. It describes how abnormal the cancer cells are compared to normal healthy cells. This can help your cancer team understand how quickly the cancer may grow or how likely it is to spread.

Both stage and grade can affect the treatment you may need. So, after tests to diagnose cancer, people often have further tests to get information about these factors.

How is cancer grading done?

A doctor called a pathologist will examine a sample of cancer cells under a microscope. The sample might have been collected during a biopsy or during surgery to remove the tumour.

How many grades of cancer are there?

This can vary depending on the type of cancer but pathologists use the following terms to describe many types of cancer:

• Grade 1, low grade or well differentiated – the cancer cells are not identical to normal cells but they look similar. Grade 1 cancers usually grow more slowly.
• Grade 2, moderate or intermediate grade – the cancer cells look more abnormal and are growing slightly faster .
• Grade 3, high grade or poorly differentiated – the cancer cells look very different from normal cells and may grow more quickly.

There are different grading systems for some cancers. Some systems also have a grade 4. Some cancer types have a specific system that is only used for that type of cancer. For example, prostate cancer grading uses the Gleason scoring system. Kidney cancer grading uses the Fuhrman system.

Is stage or grade more important in cancer?

Both can be important. Grade may be the main factor that helps your team decide what treatments are most likely to be most effective for you. But for some cancer types and some situations, the grade of the cells is just not relevant. Other factors such as the cancer stage or the specific genetic changes in the cancer cells might be far more important when it comes to planning your treatment.

Looking for more information?

You can read our general information about staging and grading. If grading is likely to affect the treatment options for a type of cancer, we also usually cover that in our information about the cancer type. Use our cancer types A-Z to search. You can also get in touch, if you have a question or would like to talk:

• Call the Macmillan Support Line free on 0808 808 00 00.
• Chat to our specialists online.
• Ask an expert.

This blog has been written by Hilary, Cancer Information Development Nurse.