TNM Staging System

In the TNM staging system, each type of cancer is assigned a "T" category, an "N" category and an "M" category. The letters in TNM staging represent the following:

T stands for Tumor. T staging gives details about the original tumor (the first tumor found, before spreading may have occurred).
- TX means the tumor cannot be evaluated.
- T0 means there is no evidence of an original tumor.
- Tis means the cancer is "in situ," or, has not spread.
- T1 through T4 describe the tumor size and status of spreading. The bigger the number, the worse the tumor is.
N stands for Nodes. N staging determines whether or not the cancer has spread into nearby lymph nodes .
- NX means the nearby lymph nodes cannot be evaluated.
- N0 means there is no evidence of cancer in the nearby lymph nodes.
- N1 through N3 describe the status of the spreading into the lymph nodes (for instance, the location, size and number of lymph nodes affected). The higher the number, the worse the status of the lymph nodes.
M stands for Metastasis. M staging determines if the cancer has metastasized , or spread, beyond the lymph nodes into other parts of the body (also known as distant metastasis, or distant spreading).
- MX means distant spreading cannot be evaluated.
- M0 means there is no evidence of distant spreading.
- M1 means distant spreading has been found.

Overall Cancer Stage

After the doctor determines the TNM staging of the cancer, he or she assigns an overall cancer stage of I, II, III or IV. For instance, breast cancer that is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body would be categorized as T1, N0, M0 and considered stage 1 breast cancer.

TNM Staging Guide
T = Tumor
TX:	Tumor cannot be evaluated
T0:	No evidence of an original tumor
Tis:	Cancer is "in situ," or, has not spread
T1-T4:	Describe tumor size and status of spreading
N = Nodes
NX:	Nearby lymph nodes cannot be evaluated
NO:	The cancer has not spread to lymph nodes
N1-N3:	Status of cancer spreading into lymph nodes
M = Metastasis
MX:	Distant spread cannot be evaluated
MO:	No evidence of distant spreading
M1:	Distant spreading has been found

The higher the overall cancer stage, the more advanced the cancer is.

The TNM staging classification system works differently in certain types of cancer, so talk to your doctor if you would like to learn more about cancer staging in your specific type of cancer.

Chemotherapy can be managed through education preparation. To be better equipped to help yourself and your family, visit the Helpful Resource section.

Important Safety Information

WARNING: Taxotere® treatment can cause serious, physically limiting, and potentially life-threatening side effects, such as infection, low blood-cell counts, allergic reaction, and retention of excess fluid (edema).

Taxotere® should not be given to patients with low white–blood-cell counts, abnormal liver function, or a history of allergic reactions to Taxotere® or any of the ingredients in Taxotere®.

Before each Taxotere® treatment, all patients treated with Taxotere® must receive another medicine called dexamethasone. This drug can help reduce the risk of fluid retention (edema) and allergic reactions.

Taxotere® should be administered only under the supervision of a qualified physician experienced in the use of anticancer treatments. Appropriate management of complications is possible only when adequate diagnostic and treatment facilities are readily available.

Treatment-related acute myeloid leukemia (AML) or myelodysplasia has occurred in patients given anthracyclines and/or cyclophosphamide, including use with Taxotere® in adjuvant therapy for breast cancer.

The most common severe side effects are low white–blood-cell count, anemia, fatigue, diarrhea, and mouth and throat irritation. Low white–blood-cell count can lead to life-threatening infections. The earliest sign of infection may be fever, so tell your doctor right away if you have a fever.

Other common side effects from Taxotere® include nausea, vomiting, hair loss, rash, infusion-site reactions, odd sensations (such as numbness, tingling, or burning) or weakness in the hands and feet, nail changes, muscle and/or bone pain, or excessive tearing.

Because of the potential risk of fetal harm, pregnant women should not receive Taxotere®. Women of childbearing potential should avoid becoming pregnant during treatment with Taxotere®.

Before receiving Taxotere®, tell your doctor if

You have any allergies
You are taking any other medicines — including nonprescription (over-the-counter) drugs, vitamins, and dietary or herbal supplements

When taking Taxotere®, contact your doctor if

You have symptoms of an allergic reaction (warm sensation, tightness in your chest, itching/hives, or shortness of breath)
You experience any other side effects

Please see adjacent page for patient information leaflet for detailed information about these side effects, and talk to your doctor about any questions you may have.

Taxotere Indications

Breast Cancer
TAXOTERE® is indicated for the treatment of patients with locally advanced or metastatic breast cancer after failure of prior chemotherapy
TAXOTERE® in combination with doxorubicin and cyclophosphamide is indicated for the adjuvant treatment of patients with operable node-positive breast cancer

Non-Small Cell Lung Cancer
TAXOTERE®, as a single agent, is indicated for the treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) after failure of prior platinum-based chemotherapy
TAXOTERE® in combination with cisplatin is indicated for the treatment of patients with unresectable, locally advanced or metastatic NSCLC who have not previously received chemotherapy for this condition.

Prostate Cancer
TAXOTERE® in combination with prednisone is indicated for the treatment of patients with androgen independent (hormone refractory) metastatic prostate cancer.

Gastric Cancer
TAXOTERE® in combination with cisplatin and flouroucil is indicated for the treatment of patients with advanced gastric adenocercinoma, including adenocarcinoma of the gastroesophageal junction, who have not received prior chemotherapy for advanced disease.

Head and neck Cancer
TAXOTERE® in combination with cisplatin and flourouracil is indicated for the induction treatment of patients with locally advanced squamous cell cercinoma of the head and neck (SCCHN).