understanding nose cancer : grading

I did a nasal biopsy in Aug 2006. The histopathology report says : "undifferentiated carcinoma". Two years later in Dec 2008, I underwent a wedge resection (a cut) on my right lung. The histopathology report says : "metastatic undifferentiated nasopharyngeal carcinoma". Do you know the difference between "differentiated" and "undifferentiated" carcinoma? (carcinoma means malignant cancer)

Cancer terminology can be rather daunting to the non-medically trained. I like to share what I found out about cancer grading from the internet library. (http://www.cancerhelp.org.uk/)

The grade of a cancer tells you how much the cancer cells look like normal cells. There are 3 grades of nose cancer.

• Grade 1 (low grade) – the cancer cells look very much like the normal nasal cavity cells
• Grade 2 (intermediate grade) – the cancer cells look slightly like normal nasal cavity cells
• Grade 3 (high grade) – the cancer cells look very abnormal and very little like normal nasal cavity cells

The word "differentiated" means how developed or mature a cell is. So you may hear your oncologist describe grade 1 cancer cells as 'well differentiated'. Grade 2 cancer cells are 'moderately differentiated'. Grade 3 cancer cells are 'poorly differentiated'.

In "undifferentiated cancer", the cancer cells are very immature and "primitive" and do not look like cells in the tissue from which it arose. As a rule, an undifferentiated cancer is more malignant than a cancer of that type which is well differentiated. Undifferentiated cells are said to be anaplastic. This is a cancer which does not appear to resemble the tissue of origin.

Differentiated cancers tend to be decidedly less aggressive than undifferentiated cancers. But undifferentiated cancer is known to respond better to radiotherapy and chemotherapy.

The grade of the cancer gives your oncologist a guide as to how the cancer is likely to behave. Low grade cancers are usually slower growing and less likely to spread. High grade cancers are likely to be faster growing and are more likely to spread. And undifferentiated cancers often grow & spread quickly.

This is only a guide. Your oncologist will consider all your test results when deciding which treatment is best for you.

References

Cancer Research UK
http://www.cancerhelp.org.uk/help/default.asp?page=13830#grade

MedicineNet
http://www.medterms.com/script/main/art.asp?articlekey=20476