Restaging information for "Newbies"

Information about restaging for Ovarian Cancer (OvCa), Peritoneal Cancer (PPC) and Fallopian Tube Cancer (FTC) "newbie" sisters on this site:

There has been much discussion on this message board about restaging ovarian cancer.
Some have posted that their physicians have restaged them after recurrence/metastasis. I found sources like the ACS and AJCC that say changing stage is done only rarely. If the criteria for restaging is not met for official restaging (see ACS info below) perhaps some physicians find it easier to refer in conversation with patients that their diagnosis now has a new stage then to say for example stage IIIc now with metastasis. Before my diagnosis, I was a medical oncology clinical trials study nurse and the physicians I worked with rarely changed the original stage and did so only in those cases noted in the ACS info copied and pasted below.
If you find source documentation for restaging other then what is posted here please reply and share your information.


This is copied and pasted from the American Cancer Society (ACS):
“A cancer's stage does not change
An important point some people have trouble understanding is that the stage of a cancer does not change over time, even if the cancer progresses. A cancer that comes back or spreads is still referred to by the stage it was given when it was first found and diagnosed.
For example, if a woman were first diagnosed with "stage II breast cancer" and the cancer went away with treatment but now has come back and spread to the bones, the cancer is called "stage II breast cancer with recurrent disease in the bones." If the breast cancer did not respond to treatment and spread to the bones it is called "stage II breast cancer with metastasis in the bones." In either case, the original stage does not change and this is not called "stage IV breast cancer." A stage IV breast cancer refers to a cancer that has already spread to a distant part of the body when it is first diagnosed. A person keeps the same diagnosis stage, but more information is added to the diagnosis to explain the current disease status.
This is important to understand because survival statistics and information on treatment by stage for specific cancer types refer to the stage when the cancer was first diagnosed. The survival statistics related to stage II breast cancer that has recurred in the bones may not be the same as the survival statistics for stage IV breast cancer.
Still, restaging may be done to measure the cancer's response to treatment or to assess cancer that has come back (recurred) and will need more treatment. This often means going through the same process that was done when the cancer was first diagnosed: exams, imaging tests, biopsies, and possibly surgery to restage the cancer. If the cancer is restaged, the stage will be recorded with a lower-case "r" before the restaged categories. A restaging process that finds T2, N3, M1, for instance, would be written rT2, rN3, rM1. The stage grouping IV would be written stage rIV rather than stage IV, to note that it is different from the stage at diagnosis. The original stage at diagnosis always stays the same. Restaging is not often done in cancer treatment, but it is more common in clinical trials. “
Source: http://www.cancer.org/docroot/ETO/content/ETO_1_2X_Staging.asp


This is copied and pasted from the AJCC (American Joint Committee on Cancer) Staging Handbook:
“Does the Stage of a Cancer Change? The formal "stage" of a cancer does not change over time, even if the cancer progresses. A cancer that returns or spreads is still referred to by the stage it was given when it first diagnosed. Sometimes, after a period of remission (cancer being undetectable) for certain cancers, if more treatment is planned, a doctor might restage the cancer. The same process that was done when the cancer was first diagnosed will be repeated: exams, imaging tests, biopsies, and possibly surgery to restage the cancer. If the cancer is restaged, the new stage will be recorded with a lower case "r" before the restaged designation. As previously stated, this is not done often.”
Source: http://www.cancerstaging.org/mission/whatis.html

PLE on this message board found and shared this information regarding restaging:
Copied and pasted from the Oncology Channel site:
“Once ovarian cancer is assigned a stage, the classification does not change, even if the cancer recurs or metastasizes to other sites within the body”.
Source: http://www.oncologychannel.com/ovariancancer/staging.shtml