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Featuring Demian Dressler, DVM and Sue Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide

Dog Cancer Words You Should Know: Grade and Stage

Updated: December 21st, 2018

I think it is important to clear up some words about dog cancer, and cancer in general.  It helps to define what you are talking about with the vet or oncologist so you can get the best info to make your decisions.

As your dog’s primary health advocate, you will be called upon to make some choices.  When that time comes, you need to have the clarity of thought to make wise decisions.

So, let’s clarify some terms!

Medical people throw the terms stage andgrade around like everyone knows what they are talking about.  They are kind of close conceptually, but are not the same.

The stage of a tumor usually refers to how far along it is.  When we say “stage”, we look at the size of the tumor, the number of tumors, and whether the cancer cells have invaded the system to travel to other sites in the body.

So a late stage tumor, or a late stage cancer, usually means it is far along.  Generally speaking, this implies it is more difficult to cure or get long term remissions.

An early stage tumor or cancer means that it is not far along.  Usually these are smaller, fewer, and have not traveled to other sites in the body other than where you find the tumor or cancer cells.

The grade of the cancer describes how aggressive it is.  This means that a low grade cancer is one that is not very aggressive, but a high grade cancer is more aggressive.

Get a copy of the Dog Cancer Survival Guide for more helpful information and tools

Aggressive cancers do things like grow quickly, invade the area right around the tumor, or get into the circulation and spread to other body parts (metastasis).  More aggressiveness means more danger.

Certain cancers have different grades.

Mast cell tumors, white blood cell tumors (lymphosarcoma, leukemia), mammary tumors (breast cancer), melanomas,  and hemangiosarcomas can vary in terms of their aggressiveness.  Some advance very quickly while others are more smoldering.  So you have different grades in single cancer types.

Osteosarcoma (the most common bone cancer in dogs) is usually aggressive. So usually this cancer type is high grade.

Different cases of cancer can have different stages too.

You could have a bladder cancer (usually transitional cell carcinoma) that is a tiny bump in the bladder wall (but has not spread) in one dog, and a large bladder mass that has spread to lymph nodes in another.

This is an example where you have the same cancer type, but different stages in different dogs.

Let’s keep the info stream going so you can best help your dog!


Dr Dressler

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  1. Antonio DiLeva on April 8, 2012 at 6:02 pm

    Our 7 year old English bulldog “ROCCO” has been diagnosed with a heart-bass mass (chemodectoma). My wife and I are devastated as he is the love of our life. We have seen a Cardiologist who placed “our little man” Rocco on Lasix (furosemide) 50mg, Spironolactone 25mg, and Benazepril. When Rocco saw the cardiologist, he was very happy and had quite a bit of energy. He also had quite a bit of fluid removed from his abdomen, which made him feel and move better. We started him on all three medicines on Friday night and gave him a second dose the following morning. He ate, drank and used the bathroom both on Friday night and the next morning. But, by mid-day saturday, Rocco seemed worse than ever … no energy, refused food and water (even his special treats). The doctor said it might be the medicine and prescribed 1/2 a pepsin AC and tums. We did not give him any medicine saturday night. Per the doctor’s orders, we started Rocco on Lasix again this morning. The vet recommended we gradually introduce the other two medicines on Monday. Rocco has improved a little after vomiting this morning. He’s had small pieces of chicken and drank water. He is still very tired, and doesn’t get up much. We have a follow up appt next Saturday to check Rocco’s kidney levels, but we want to be sure he’s ok before then. Can the medicine cause these types of side effects? We can’t tell if it’s the tumor or the medicine since, just two days ago, he was his normal happy go lucky self. Thank you!

    • Dr. Demian Dressler on April 12, 2012 at 2:02 pm

      Dear Antonio,
      I am sorry about your Bulldog, this must be very difficult. As to side effects, yes, the meds could be the culprit but so could the cancer and I cannot ascertain which it is over the internet, I am sorry. Please check with your vet on this.
      Dr D

  2. audrey wright on March 21, 2012 at 10:11 pm

    my dog who has had a grade 3 tumor removed last august since then he has had a terrible smell coming from him i have had his teeth done and also had his glands cecked do you know what the smell might be.

  3. Betsy C on March 20, 2012 at 7:06 pm

    Claudine, I would take your dog to a holistic vet ASAP. I was reading up on alternative treatments such as IP-5, artemisinin, beta glucan, and Neoplasene and if you feel your dog still is feeling well enough, go for it!

  4. Linda ONeill on March 18, 2012 at 4:26 am

    Please help. My beloved 16 year old bichon was just diagnosed this week with lymphoma. He has been healthy except for a history of allergies treated with prednisone when he was younger and chronic renal failure with elevated BUN at 42 though creatinine normal. He had developed severely swollen lymph nodes especially visible around his neck and stopped eating and drinking one day. the next day his diagnosis was confirmed with ultrasound, cytology and biopsies. we are still awaiting results but stage 4 at least is suspected. they did not think he could handle the madison wisconsin protocol so he was started on adriamycin. He started having diarrhea and some vomiting day 3 and now on day 4 he is miserable and has not eaten for 3 days. He was at emerg clinic 2 nights ago and he was given shot for nausea which helped and next day went to vet(not his as a saturday) and he was given hydration, something for nausea, diarrhea, pain and his 20 mg of prednison he has been on for first 7 days following chemo. Cannot get him to eat. He has not slept but just cries. so hard to give him pills and when we do we are forcing him and he has empty stomach. any ideas at all.

    • Dr. Demian Dressler on March 21, 2012 at 3:29 pm

      Dear Linda
      he needs to go back to the vets for further supportive care ASAP.
      DR D

  5. Claudine on March 17, 2012 at 5:07 pm

    Dr. Dressler,

    Our 2 1/2 year old boxer, Abbie, has had significant weight loss in the last two months – most recently over the last 2 weeks there has been a bit of a cough, some throwing up and a bit of loose stool. She just this week started having dizzy spells and collapsing after overexertion. We immediately got her to our vet assuming it was related to her heart – however the vet couldn’t hear a murmer. We were referred to a cardiologist at UPENN who after an ultrasound concluded her heart was fine – but slighting higher in her rib cage. An ultrasound of her abdomen revealed multiple, large, irregular masses – some associated with the liver and others associated with the right adrenal gland, lymph nodes, and possibly the pancreas. Some masses also appeared to be invading large blood vessels with the abdomen. A needle aspirate was obtained and showed a malignant cell identified as “neuroendocrine carcinoma.” We were advised that because multiple organs are involved and the size of the masses – surgery was not an option. We were also advised by the oncologist that this type of cancer does not respond to chemotherapy.
    I left UPENN stunned. We went in thinking we would leave with beta blockers for a heart condition and we ended up with a death sentence for a 2 1/2 year old dog – and imminent death due to the agressive nature of this cancer and its location. Other than a very obvious weight loss and sleeping a bit more she is acting as she always did – happy young dog. I really got the message from all of the docs we saw yesterday that we should plan to put her down immediately as her cancer is moving fast and she will likely suffer a rupture and suffer instant death – soon.
    They told me this was a very rare form a cancer in dogs and also very rare for a 2 1/2 year old. As a result it is very hard to find info online or others with the same diagnosis on these blogs. I’m trying to get an idea of when we need to put her to sleep. It’s a no brainer for the obvious (not eating, wasting away, pain. . . ) – however, they made it sound like I won’t get those warning signs and she can just suffer a rupture. It is very hard to put a dog down who is still kissing you and smiling. . . but I also don’t want her to suffer through a rupture or traumatic death. Any thoughts?

    What do you know about end stages of this type of cancer? Will we see signs

    • Dr. Demian Dressler on March 21, 2012 at 3:26 pm

      Dear Claudine,
      perhaps this blog post will help you:
      Sudden ruptures are pretty fast and if you look at the big picture this is a young dog, so my opinion (at a distance) is to give her some time to enjoy her life.
      I would be thinking deliberate life quality increases as discussed in the Guide, dog cancer diet, and discuss with your vet the use of apocaps, high dose vit C =/- vit k3, neoplasene, artemisinin, and the other steps in the Guide.
      I hope this helps
      Dr D

  6. Sheri on March 5, 2012 at 2:01 pm

    Detroit, my 10 yo Rottie has a nasal tumor. He had a bloody nose 2 weeks ago so I rushed him in. The bleeds are heavier some days, eye dischare has started out of same side as nostril thatblleds and I can see a swollen area on the same side bridge of his nose assuming this is the tumor. I can not afford the rhinoscopy but am positive this is a nasal tumor. My 16 year old son just lost his Dad unexpectedly (only 41) 5 weeks ago, he is devastated and his dog has been his only comfort, and now this. I am desperate. I started the budwig protocol out of desperation today. I can’t let me son lose his dog right after his father. Please send me some guidance. I am so sad, I need your guidance and any help you can offer. Thank you, sheri 817-789-3770

    • Dr. Demian Dressler on March 7, 2012 at 12:35 pm

      Dear Sheri
      I am very sorry you and yours are experiencing this. It sounds like so much to bear.
      You have your work cut out for you. You must become a real guardian (vigilant protector).
      1. use methods to discharge your emotions so you have a clear mind (a good number are in the Guide)
      2. get a support network, friend, counselor, family, advisor, spiritual guide, online group to help you through this and check in with them regularly
      3. get veterinary supervision for all the steps I discuss
      4. get Detroit on a proper dog cancer diet (free dowload on this blog at top of the page)
      5. educate yourself on the options based on cancer type: surgery, chemo, radiation. Find out how far it has spread (staging)
      6. find out the side effects, logistics, cost, and time involved for each treatment type. Take steps to minimize these (in the Guide).
      7. find out the benefits (added life expectancy) you get for these conventional treatment steps to help your decisions.
      8. learn about supplements: apocaps, neoplasene, artemisinin, omega-3, beta glucans (AHCC or K-9 immunity), and the other highest priority supplements in the Guide. Don’t get confused listening to people who act qualified but actually are not.
      9. schedule deliberate increases in life quality daily for Detroit- massage, play dates, trips, etc.
      10. find an integrative vet if you want all the tools for your dog. Talk to this person about high dose vitamin C injections with or without vitamin k3 injections. Discuss risks of nasal bleeding with this approach (which can be severe).
      11. control any pain (talk to your vet)
      12. insure at least 7-9 hours of sleep in total darkness for Detroit

      I hope this helps to get you on the right track and also benefits other readers of this thread
      Dr D

  7. Genevieve Munden on February 5, 2011 at 5:23 pm

    Dear Dr. Dressler,

    My schipperke Pete was diagnosed with oral melanoma (pictures on his website/blog at…also acts as my therapeutic journal).

    He is 15 and I have elected not to put him through radiation or canine vaccine for various reasons. His mitotic index was 27 and margins were not clean so when it grows back his vet will debulk until this is no longer an option.

    The visit to the oncologist proved that the spots on his lung x-rays were typical forms of calcification for a dog his age and his lymph nodes were not swollen. The regular vet could not aspirate the lymph nodes due to this fact. Even though this appears to be ‘good’ news, I know the cancer is very active so I have been doing as you say in your book and making him feel special and it has been working amazingly!

    He is very happy and eats like a pig but here lately his appetite is dwindling a bit, a sign of what you are calling decompensation. So, I am anxiously looking for new diet. He is on n/d with SurpaGlan and ES-Clear Supplements from His alkaline phosphatase had gotten to 1601 and the SupraGlan dropped it to 351 so I still have him on that. The ES-Clear is for boosting the immune system. I am not sure if this is the right diet for him. People tell me that the high fat in n/d could lead to pancreatitis. I see that you suggest many different supplements and I am a bit confused as to what to use, some of which have to be discussed with my vet and she probably has no idea how to guide me on these. Is there a diet better than n/d prescription for cancer or do you think this is ok. I don’t have a lot of time in the morning to cook him meals however if I could cook up a batch on Sundays to last the week. I guess I am looking for the perfect diet to ‘starve’ or better yet ‘kill’ this cancer. I don’t know if ‘killing’ it is an option or the right word but maybe putting it into ‘remission’ so to speak.

    • DemianDressler on March 8, 2011 at 9:27 pm

      Dear Genevieve,
      it is important to remember you can only do what is possible for you. You might want to dowload the free dog cancer diet pdf on the top of this website page. In cases where it is too much to cook all the time, make a big batch and save it in the refrigerator for up to a week. You can mix it in the other diets too.
      Have you downloaded the Guide? There are doses and such that may help your vet. The easiest and arguably most effective supplement is Apocaps, which you can introduce your vet too as well. There is useful info on the FAQs page at
      I hope this helps,
      Dr D

  8. Joyce Smith on December 7, 2010 at 2:55 am

    My dog Zen was diagnosed with Stage 3 Lymphoma (to the best of their knowledge). We couldnt get an exact reading because we didnt have enough blood left (wrong tests run) to accurately determine if he was 3 or 4. We brought him in to the vet because for diarrhea that he was medication for Colitis which did not go away. When I took him in the vet the latter time noticed his lymph nodes were enlarged – all of them. We immediately started him on the Wisconsin Protocol and he went into remission the very first week! Wow, we thought, wonderful and amazing. His diarrhea disappeared. He was going weekly for the first 8 sessions. As soon as he started the 2 week session, he relapsed. They also had given him a generic – I dont know the name of the drug off hand, but this was just recent – (late Nov 2010) they were saying it is 98% the same as the real thing…when he relapsed, they recommend he stop the Wisconsin Protocol and to instead go on Lomustine. They gave him the L-Spar to get him back into remission, then a week later the CCNU. He spit up something yellow in a few places 1 day after the CCNU treatment. We administered it ourselves. It has been a week and I am pretty sure his lymph nodes are enflamed again. With all this I have a feeling the news isnt good and so far we are barely @ 3 months remission. What can I expect at this time>

    • DemianDressler on December 8, 2010 at 8:28 pm

      Dear Joyce,
      I am sorry to hear this news. Since you are relying exclusively ( I think) on conventional care, I wanted to make sure you are seeing a board-certified oncologist?? Other options for rescue:
      MOPP, DMAC, DTIC, vinblastine, asparaginase
      I would also pay attention to diet, apoptogens, immune stimulating supplements, and brain chemistry modification discussed in the Guide..

  9. Casey on November 4, 2010 at 5:26 pm

    Hi Dr Dressler,

    My pug was diagnosed with adenocarcinoma. Local vet said it’s anal sac adenocarcinoma. It started in her vagina. At first we were thinking it was TVT or Transmissible Venereal Tumor since she was previously mated by a stray dog. So after surgical removal of the tumor, we put her into 3 weeks chemotherapy. She lost weight because of vomitting and had no appetite at all 3 days after chemotherapy. After 3 weeks we decided not to continue knowing that the tumor was malignant and that the biopsy findings was of anal sac adenocarcinoma. We put her to Artemisinin, Transfer Factor, and antioxidants/supplements. No more than 2 months the tumor came back, the same place on her vagina, with about 2mm size accdg to the vet. We are continuing on her medicines and am still searching on what more to give. Would you think her type of cancer is easily curable? I’ve read on your blog posts that it is very critical that we know what type of cancer we are dealing with. Hope you can enlighten me. I am from the Philippines and I think vet technology is far more better in the US. Thanks!

  10. Laurie on September 21, 2010 at 8:11 am

    Dear Dr. My 11 yr old friend, mixed breed 21 lb dog was panting more than usual. He vet found a large mediastinal mass. I immediately made an appt with an oncologist who confirmed it was a cranial mediastinal lymphoma, no pleural effusion noted. a needle aspriation confirmed the diagnosis.They gave her beneadryl, elspar and prednisone yesterday in order to give me some time to decide upon treatments. The Madison Wisconson Protocol and a lessor protocol of CCNU, vincristine and prednisone given concurrently. I have been out of my mind and unable to decipher the right thing to do. can you tell me if either of the protocols fair better with her quality of life and/or if there is a ‘real’ chance of putting this cancer into remission? I love my girl and want to do the right thing for her and for me.

    • DemianDressler on September 29, 2010 at 8:49 pm

      Dear Laurie,
      about 8 to 9 out of 10 dogs will go into remission with these protocols. So your friend has a real chance!!
      All my best,

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