Understanding your cancer diagnosis

Plain-language help with the words in your cancer reports: pathology report, type, grade, stage, TNM, biomarkers and receptors, and what localized, advanced and metastatic mean.

6 min read · last reviewed September 30, 2026

After a cancer diagnosis, you may get reports full of words you have never seen before. It can feel like reading a foreign language. This guide explains the most common terms in plain words, so you can follow along when your team talks about your cancer.

Every cancer is different, and some cancers (like blood cancers) use their own terms. Your team is the best guide to your own reports. Use this page as a starting point for your questions.

What is cancer?

Your body is made of trillions of tiny cells. Normally, cells grow, divide and die in an orderly way. Cancer starts when some cells change and begin to grow out of control. They may form a lump, called a tumour. Cancer cells can sometimes spread into nearby tissue, or travel to other parts of the body.

Cancer is named after the place where it started. For example, breast cancer that spreads to the bones is still breast cancer, not bone cancer. This matters, because it guides the treatment.

Your pathology report

A pathologist is a doctor who looks at cells and tissue under a microscope. After a biopsy or surgery, the pathologist writes a report for your team. It may include:

• Diagnosis: whether cancer is present and what type it is. This is usually the most important part, and often appears near the top.
• Size of the tumour, if it was removed.
• Grade: how unusual the cells look (see below).
• Margins: after surgery, whether cancer cells were seen at the edge of the tissue removed. "Clear" or "negative" margins mean no cancer cells were seen at the edge.
• Lymph nodes: whether cancer was found in any lymph nodes that were removed.
• Biomarkers: special tests on the cancer cells (see below).

Some results take longer than others. It's common to get results in pieces over a few weeks.

Grade: how the cells look

The grade describes how different the cancer cells look from normal cells.

• Low grade (often grade 1): the cells look fairly close to normal. They tend to grow more slowly.
• High grade (often grade 3): the cells look very different from normal. They tend to grow faster.

Grade is only one piece of the picture. A high-grade cancer can still respond very well to treatment. Some cancers use their own grading systems, so ask your team what your grade means for you.

Stage: how big and how far

The stage describes how large the cancer is and whether it has spread. Your team uses it to plan treatment. Stage is usually worked out from scans, blood tests, biopsies and sometimes surgery.

TNM, in plain words

Many cancers are staged using the TNM system:

• T (Tumour): how big the main tumour is, and whether it has grown into nearby tissue. Higher numbers (T1 to T4) mean bigger or deeper.
• N (Nodes): whether cancer has reached nearby lymph nodes. These are small, bean-shaped parts of your immune system. N0 means no cancer in the nodes. N1 to N3 mean some nodes have cancer.
• M (Metastasis): whether cancer has spread to distant parts of the body. M0 means it hasn't. M1 means it has.

Your team then combines the T, N and M into an overall stage, usually written as a number:

• Stage 0: abnormal cells are present but have not spread into nearby tissue. This is sometimes called "in situ."
• Stages 1 to 3: cancer is present. Higher numbers usually mean a larger tumour or more spread into nearby tissue or lymph nodes.
• Stage 4: cancer has spread to distant parts of the body.

You might see a small letter before the TNM, such as "c" (based on exams and scans) or "p" (based on surgery and the pathology report). Don't worry if these details are confusing. Your team can explain.

Localized, advanced and metastatic

You may also hear these words:

• Localized: the cancer is only in the place where it started.
• Regional or locally advanced: the cancer has spread to nearby tissue or lymph nodes.
• Metastatic (or distant): the cancer has spread to other parts of the body.
• Advanced: usually means cancer that is unlikely to be cured, but can often be treated and controlled. Some people live with advanced cancer for a long time.

Hearing "metastatic" or "advanced" is hard. Please remember that there are more ways to treat and control these cancers than ever before. Your team can talk with you about what treatment can do for you, and palliative care can help you feel as well as possible at every stage.

Biomarkers and receptors

Biomarkers (also called tumour markers) are genes, proteins or other features of a cancer. Testing for them can help your team choose the treatment most likely to work. Some treatments, including many targeted therapies and immunotherapies, only work for cancers that have certain biomarkers.

Examples you may hear about:

• Hormone receptors: some cancers, such as many breast cancers, have receptors that let hormones fuel their growth. These cancers may be treated with hormone therapy.
• Protein or gene changes: some cancers have a change in a particular gene or protein. Certain targeted medicines are designed to block it.
• Markers that guide immunotherapy: some tests help predict whether immunotherapy may help.

Biomarker tests are usually done on the tumour tissue, and sometimes on blood. They are different from genetic tests for inherited changes that run in families. Ask your team if either kind of testing is right for you.

Keep it in perspective

It's natural to look for numbers online. But averages are based on large groups of people, often treated years ago. They can't tell you what will happen to you. Your team knows your cancer, your health and your treatment. Ask them what they expect, and ask how your stage and grade affect your options.

Something you can do today: Ask for a copy of your pathology report and write your questions in the margin.

Questions to ask your care team

• What type of cancer do I have, and where did it start?
• What is the grade and stage? What do they mean for my treatment?
• Has the cancer spread to lymph nodes or other parts of the body?
• Have biomarker tests been done? What did they show?
• Should I have genetic testing for inherited cancer risk?
• Are there any results still to come?
• Can I have a copy of my reports?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

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