Staging and grading children’s cancers

The tests your child has will help the doctor to stage and grade their cancer. 

• Staging describes where the cancer is and if it has spread.
• Grading describes the cancer cells – what they look like and how quickly they might grow.

Knowing the stage and grade of the cancer helps the medical team plan the best treatment for your child.

How is cancer staged?

There are different ways of describing cancer stages. It depends on the type of cancer. 

TNM staging

If the cancer has caused a tumour, your doctor may use the TNM staging system. This refers to:

• The size of the tumour (T)
• If there is cancer in the lymph nodes (N)
• If the cancer has spread to other parts of the body (M for metastasis)

Number stages

Often cancers are given a number stage from 1 to 4. A higher number, such as stage 4, means a more advanced cancer.

How is cancer graded?

A cancer grade describes how abnormal the cancer cells and tissues look under a microscope. It is an indicator of how quickly a cancer is likely to grow and spread.

Most types of brain tumours are graded on a scale of 1 to 4 by the World Health Organization (WHO).

• Grade 1 is considered very slow growing while grade 4 tumours grow more rapidly or more aggressively. The grades provide some information as to how malignant/cancerous the tumour is.

Cancer can also be referred to as low grade or high grade

1. Low-grade cancer. The cancer cells look only slightly abnormal, much like normal cells. The cancer is usually slow-growing.
2. High-grade cancer. The cancer cells look fairly or very abnormal and are more likely to grow quickly.