Cancer : Detailed Guide

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Tumor grade

Your prognosis is affected by the type of cancer you have, but it is also strongly influenced by the cancer's stage. For some cancers, another important factor that is considered along with clinical stage is tumor grade. The grade is assigned after a biopsy of the cancerous tissue has been examined. Tumor grade describes how different the cancer cells look compared to normal ones.

Tumor grade is considered when making treatment decisions and is another factor that affects prognosis for some kinds of cancer. The grade of the cancer reflects how abnormal the cancer cells look under the microscope. Grading is done by a pathologist who compares the cancer cells from the biopsy to normal cells. (A pathologist is a doctor who is specially trained in diagnosis and classification of diseases by lab tests, such as looking cells under a microscope.) Grade is important because cancers with more abnormal-looking cells tend to grow and spread more quickly. Higher grade cancers (meaning that the cancer cells look very abnormal) usually have a worse prognosis, and sometimes need different treatments.

The American Joint Committee on Cancer (AJCC) recommends the following cancer grading classifications:
* GX: Grade cannot be determined
* G1: Well-differentiated (the cancer cells look a lot like normal cells)
* G2: Moderately well-differentiated (cancer cells look somewhat like normal cells)
* G3: Poorly differentiated (cancer cells don't look much like normal cells)
* G4: Undifferentiated (the cancer cells don’t look anything like normal cells)

The lower the cancer grade the better the prognosis. G1 cancers are linked to the best outcomes. G4 is associated with the worst outcomes and the others fall in between.
There are problems with grading, though. For example, several different grade levels may be found in one tumor or the tumor grade may change with time.

There are also several grading systems for different types of cancer, such as the Gleason grades for prostate cancer or the Kernohan grades for brain tumors. Each grading system divides cancer cells into those with the most abnormal cells, the least abnormal cells, and those in between. Generally, whatever grading system is used, the lower numbers indicate less aggressive cancers while the higher numbers suggest more rapid cancer cell growth and spread.

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