Do doctors not always give stages for cancer? My friend says her doctor didnt?

By David Chan, MD from UCLA, Stanford Oncology Fellowship Via Quora

Stage is only a description of cancer location to guide treatment. It’s not a prediction of life expectancy and stages don’t translate across different cancers. Cancer stage is not is a grading system of cancer survival.

I can cure most stage 4 lymphomas. I can’t cure a stage 1 GBM of the brain. I also can’t cure a stage 4 breast cancer but that patient will generally outlive a stage 3 pancreatic cancer or any stage GBM by many years unless her breast cancer is triple negative. Some stage 4 prostate cancer patients can survive a decade without needing treatment or very minimal treatment depending on Gleason grade.

Some stage 4 colon cancer patients with limited metastasis to the liver can be cured with directed therapy to the liver and chemotherapy. Some stage 4 lung cancers with EGFR mutation survive many years while others have shorter life expectancy (EFGR, ALK, ROS1, NTRK fusion mutation and PD-L1 negative).

I often don't give a stage for cancer unless asked because it doesn't add much to the patient’s understanding of prognosis and treatment options. I will if asked and some patients on learning that they have stage 4 ER positive or HER2 positive breast cancer gasp thinking that they have about 6 months when they more likely have 5–10 plus years of life expectancy with modern therapy.

It’s complicated. The other thing I don’t like about staging is that patient often will google their survival without understanding that most survival numbers are based on data from 10–15 years ago don’t include many of the new treatments in many cancers.