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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. Mary on April 10, 2013 at 8:16 am

    Please help – scared to death!
    My 11 1/2 year old female Lab has an ulcerated mass on here anus. Vet says it looks malignant, and is sending out to special pathology place for difinite answer. I have been trying to research this, and can’t find much information. My girl has an underactive thyroid that has been well controlled with medication. Eats well, drinks well – the only real difference I see in her is she seems to be more tired. I am scared to death, and scared – she is truly my very best friend. Please help. Thank you

  2. Bonnie Landau on March 11, 2013 at 5:47 pm

    My 11 1/2 year old English Bulldog has been panting excessively on and off for about six months. Two years ago she had a front leg amputated due to a fibrosarcoma but has done wonderful since then. This weekend we rushed her to the vet because the panting was non-stop from 7am to 10pm. After bloodwork, X-rays, ultrasounds and an echocardiogram she has been diagnosed with a chemodectoma. It is putting pressure on her pulmonary artery and that is what is causing her panting. Her heart is not able to pump enough blood/oxygen to her lungs.
    We are told that there is nothing that can be done. We were given a low dose sedative to help her stay comfortable if the panting gets too much but it seems to just knock her out. Is there anything we can do to help her breathing or be more comfortable but still be awake to be herself? Are there any supplements or anything that could possibly help her at all? I know she is old for a Bulldog but she is still so much herself. Her appetite is still normal, she’s happy etc.
    Last question, I also have her brother (true litter mate) is he at risk for this too?
    Any ideas or suggestions would be greatly appreciated.
    Thank you

  3. pam on January 27, 2013 at 8:24 pm

    I can relate to the unbelievable stress you are going through!! I have recently been through perhaps a similar experience. My 12 year old Mini Schnauzer was recently diagnosed with an aggressive form of mast cancer, fortunately, it turns out she had a low grade tumor and the removal was within the clean margins. Our family has been with a wonderful vet for 30+ years, they recently sold the practice to a national veterinary practice “VCA” Sad, but true, the national practice that bought our local veterinary practice, prays on their clients love for their pets and wants to take the pets through the new and most modern therapies.
    My beloved Vet, about to retire (and I know through conversations he does not believe in the new owners recommendations) told me, if you have the malignant tumor removed with “clean margins,” he would not put his own pet through chemo therapy at such an old age.

    I am truly THANKFUL FOR OUR VET, and his honesty, at age 12, you do not put your pet through chemo after a surgery generates a “clean margin” report !!!

  4. Yvonne on November 18, 2012 at 8:40 pm

    Hi Dr. Dressler,

    Our 15 month old Bulldog has been diagnosed with Mediastinal Lymphoma, and had hypercalcemia too. He was diagnosed by ‘accident’ when he swallowed a treat whole and ended up in pain at the vet ‘s office. His symptoms were hard to pick up on since he was already on Prednisone for allergies and it mimicks the lymphoma symptoms. He lost 6 pounds in the week he was diagnosed even though he was eating twice as much. He is otherwise healthy and happy.

    He has a 7cm tumor with some pleural effusion. He was given Elspar on the spot and we have him in the Wisconsin Madison protocol, week 2. He had a bad reaction to the Vincristine and has to have lower doses from now on. Even though we are with a great specialist, our oncologist doesn’t give enough information and we feel out of control. She says its useless to grade the cancer since it won’t change her recommended protocol. She said the same about checking to see if its spread to any organs. He has no noticeable external node swellings and the ultra sound showed no swellings besides the tumor. His blood tests are showing normal white blood cell counts although elevated BUN and creatine. Reading everyone’s stories it just seems like we are not getting enough diagnostic testing done. How important is it to know the cancer stage? Should a biopsy be done? He had a fine needle aspiration which diagnosed the lymphoma but that’s it.

    Secondly, he has picked up his lost weight again and apart from getting tired more quickly, he seems healthy. How could our pup look so normal if he has lymphoma? Also, why is it more aggressive in such a young dog? (15 months old). I would have thought younger dogs could withstand chemo better and are stronger than older dogs? His calcium levels have returned to normal. No fevers, no classic symptoms besides the panting. What are his chances of surival?

    Are there any cases of dogs suriving mediastinal lymphoma more than 4 or 5 years?

    Why do humans with this type of lymphoma have much better chances than dogs? Aren’t dogs getting the same chemo? Apart from chemo and supplements etc,, what else can we do for our pup? I’ve been reading about bone marrow transplants? Any other new biological procedures available to train his immune system to fight the cancer? We don’t want to lose out little guy. We are prepared to do anything but there is just too much info out there for us to disseminate by ourselves as laymen. Please help? Any advice would be great

    • Dr. Susan Ettinger on November 24, 2012 at 6:17 pm

      Sorry to hear about your Billie. As for staging tests, they are not useful to do once chemo has started, so I would not worry about it at this point. Focus on treatment.
      Most dogs seem quite normal and fell well, which is a great thing. Yes you are sadly correct that being younger is a negative prognostic predictor. Some think that may have genetic predisposition to developing lymphoma, so it is more aggressive. Remember stats are never a guarantee – good or bad. I have had young dogs with T-cell hypercalcemic lymphoma do better than B-cell lymphoma dogs, despite what statistics tell us.
      Can your dog live 4 to 5 years? It is unlikely but possible. I had a dog live over 7 years, but some do not. Cautious optimism is what I recommend.
      There is more info on lymphoma in the Guide and I wrote a series on stats on the blog. Start here:
      I hope your dog outlives all the stats!
      All my best, Dr Sue

    • Dr. Demian Dressler on November 27, 2012 at 11:24 am

      Dear Yvonne,
      so sorry to hear of such a young dog with cancer :(- heartbreaking. The first thing is to “guard the guardian” as stated in the Guide (emotional releasing exercises really help clear the mind substantially). i agree with the oncologist in this case regarding staging. why put the dog through it and spend the money if it is not actionable? Have you followed the step in the guide about getting a copy of the path report and a second opinion if you have these doubts? As to survival, that is very long and would be rare. Rarely dogs have lived that long but very very infrequently. As to what else can you do, this is written in the Guide, which you should read. Diet, apoptogens, immune support measures, brain chemistry modification, etc.Advanced conventional care for LSA also is in there. for immediate info on marrow transplant:
      Dr D

  5. Leslie on October 8, 2012 at 11:18 am

    6 months ago, my 7 (2 weeks away from being 8) year old lab mix was diagnosed with idiopathic paricaridal effusion. I had them tap his heart to drain the fluid because he was going into right heart failure. echograms xrays ultrasounds blood panels and more, and $2000 later there was no known cause. A week after the fluid was drained it came back just as aggressive (in 24 hours he gained 6 inches in the circumference of his stomach) and I called my family and I put him down with us all there with him. it was the hardest thing I’ve ever done in my life, holding onto him while he took his last breath. Fast forward to now, I go to my parents house on friday and notice my moms 9 year old golden retriever is bloated. We leave for the weekend (my step dad watching the dogs) and come home on sunday and her stomach is grotesquely bloated, huge and pregnant looking. Extremely unwell, lethargic and sad. She is diagnosed today with the same thing as my baby was. These two dogs are 1 year apart, dying 6 months apart, they have lived together their whole lives. How can this happen to both of our dogs, so close to each other? could it be their food? something environmental? What could have caused this?

  6. Julie on September 15, 2012 at 9:03 am

    if your dog is dying from cancer is it safe to have a vet give the dog a rabies shot?

    • Dr. Demian Dressler on September 19, 2012 at 3:39 pm

      I would avoid it!
      Dr D
      ps see if the vet will settle for titers!

  7. Tirzah Hoffmann on September 15, 2012 at 2:26 am

    Dear Dr. dresser, my 11 yr old rottweiler had recently stopped eating her dry food and I sensed something was not right, in fact, I had taken her to our vet months ago to check on her stomach as it seemed as though she may have had some sort of mass beginning to take place (seemed harder and fuller). I took her in this week, X-rays showed her spleen is pushed way lower than where it should be, and there seems to be some sort of large mass type there. The vet does not have ultrasound in their office so they scheduled for someone to come in and do it next Wednesday. I’m worried if it is something with her spleen which he mentioned was a possibility, it could burst before then, or if it is a mass, perhaps I could get it taken out and she will end up being fine. She is starting to show discomfort, getting up several times throughout the night and laying back down again. I don’t want her to be in pain, should I take her to another place for ultrasound sooner? I just want to do everything right for her, as she has been my best friend and best dog anyone could ever ask for. Thank you.

    • Dr. Demian Dressler on September 19, 2012 at 3:44 pm

      Dear Tirzah,
      it is always best to get the info sooner, so don’t hesitate to get that done!

  8. RINA on July 19, 2012 at 7:15 pm

    Hi there, I have two adopted female dogs at home. One a rescued stray mongrel, the other a rescued miniature schnauzer. The Stray Mongrel has Canine Tvt, I am aware that it is contagious by mating, sniffing and licking. Will my mini schnauzer contract the TVT as well? What should I do to prevent the mini schnauzer from contracting tvt and how can i safeguard other dogs that visit my home?

    • Dr. Demian Dressler on July 24, 2012 at 9:06 pm

      Dear Rina,
      the Guide discusses treatment of TVT. Please consult your vet on how to treat this problem so the odds of other dogs getting it goes down. Until then, keep them separate and separate bowls to be extra safe.
      Dr Dressler

  9. jennifer on June 12, 2012 at 1:53 am

    I have a golden with lymphoma and we are trying doxorubicin every 3 weeks. She had her first treatment 11 days ago and the lymph nodes are down only slightly. Does this mean it isn’t working or might it take longer? Should she also be on prednisone? She is getting doxycycline as well and we were considering adding Previcox but not sure if that should be used if we add the pred. Thanks so much for any guidances. She has benn totally asymptomatic, eating and acting very well. She is 13.5 years old so pretty old for a Golden.

    • Dr. Demian Dressler on June 14, 2012 at 12:19 pm

      Dear Jennifer
      Yes, this can mean both actually. You will want to give a little more time. As to the specifics on the chemo for your dog, this is a question for your oncologist. Why are you adding the Previcox? Definitely don’t use this with the pred. Your vet/oncologist again should be helping with cross-drug interactions.
      Have you also read the Guide? Considered the special dog cancer diet, apoptogens, immune support, brain chemistry modification, etc…? These things can make a significant difference.
      All my best
      Dr D

  10. Sandra Dighton on April 19, 2012 at 4:31 pm

    I was wondering if the lymph nodes shrink and grow off and on over the course of chemo? My Welsh Corgi, Casey, was diagnosed with lymphoma about six weeks ago and things are still pretty new. He is on the CHOP therapy and is on an off week this week….just blood work. Please advise….

    Thank you, Sandy

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