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Explainers written by our clinical editorial team on how diagnoses are made, staged and monitored.

Oncology · 7 min read

How cancer staging works: TNM explained

T describes the primary tumour, N the regional lymph nodes and M distant metastasis. Understanding what each letter means makes treatment discussions far easier to follow.

The TNM system, maintained by the UICC and AJCC, is the most widely used framework for describing how far a solid tumour has spread. T is graded from Tis (carcinoma in situ) through T1 to T4 by size or local invasion, N from N0 to N3 by the number and location of involved regional lymph nodes, and M as either M0 or M1 depending on whether distant metastasis is identified.

Clinical stage, written with a c prefix (for example cT2 N1 M0), is assigned before treatment using examination and imaging. Pathological stage, written with a p prefix, is assigned after surgical resection when the specimen has been examined histologically. The two do not always agree, and a change between them is a common reason patients seek a second opinion.

Stage alone does not determine treatment. Tumour grade, receptor and biomarker status, performance status and comorbidity all influence what is offered. This is why the same stage can lead to different recommendations in two different patients.

Imaging · 6 min read

Reading your own radiology report

Radiology reports follow a predictable structure: clinical indication, technique, findings, and impression. The impression is where the reporting radiologist states what they believe the findings mean.

Reports usually open with the clinical indication supplied by the requesting clinician, then describe the technique, including whether intravenous contrast was administered and which sequences or phases were acquired.

The findings section is descriptive. Phrases such as 'no acute intracranial abnormality' or 'unchanged compared with the prior study of 14 March' are statements about the images, not conclusions about your health.

The impression is the radiologist's interpretation. Hedged language such as 'cannot be excluded' or 'correlate clinically' signals genuine uncertainty and is usually a prompt for further testing rather than a diagnosis.

Incidental findings — an unrelated abnormality noticed on a scan performed for another reason — are common and frequently benign, but they should always be discussed with your treating clinician.

Care pathways · 5 min read

What a multidisciplinary team meeting actually decides

An MDT brings surgeons, oncologists, radiologists, pathologists and specialist nurses together to agree a recommendation. The recommendation is advisory, and your consent remains central.

MDT meetings review histology, imaging and clinical fitness together so that decisions are not made from one discipline's perspective alone.

The output is a documented recommendation, which your treating clinician then discusses with you. You remain entitled to decline, to ask for alternatives, or to seek an independent opinion before consenting.

MDT outcomes are recorded in your notes. Requesting a copy is a reasonable and common request, and those notes are among the most useful documents to include in a second opinion.

These articles are general education reviewed by our clinical editorial team. They are not tailored to your circumstances and do not constitute medical advice, diagnosis or a recommendation to start, stop or change any treatment.