The TNM Staging icon defaults to the catagory "RadOnc" on your PDA. When you click on the TNM Staging icon the application will launch, an introductory splash screen will appear for about 1 second, and then the main application page will appear as in the next picture.

The application will return to the anatomic site that was active the last time you used it, prostate staging in this example.

Clicking on the handhelds dedicated menu button, or, alternatively, the TNM tab in the upper left corner, invokes the options menu. These are dialogs that provide some additional info about the program.

For instance, this is the "About TNM" dialog. Click the OK button to return to the application from a dialog. In some versions of TNM, a small number (1,2,4,8 or 16) appears in the lower right corner of this dialog. This number is related to the current color depth of your screen. Should the program have problems running on your particular model of handheld, email the author at astrahan@usc.edu and mention this number.

There are 3 important menus in TNM. They are highlighted in yellow in this picture. The upper two menus are used to select the anatomic site for staging.

First, choose a general grouping from the anatomic group menu, such as Genitourinary in this example.

Next, use the anatomic Site: menu to choose a specific site, such as Prostate, within the group.

After selecting an anatomic group and site, such as Prostate in this example, select a data entry page from the TNM: menu. You can also cycle between available TNM pages using the [<-] and [->] buttons near the bottom of the screen.

On the "T" page, scroll through the selections until you find the appropriate primary tumor (T) status. The ellipsis in the lower right corner of the description of stage T2a indicates that the text exceeds the available display space and can be revealed by further scrolling of the table. Use the hardware scrolling buttons on your handheld or the table scrolling triangles in the lower right corner of the screen to scroll the display table to reveal additional checkboxes and T values.

Check the appropriate T box, T4 was checked in this case. Use only one of the "T" pages (ie you can use T or pT, but not both). If the amount of text in a field description exceeds the available display space in the table, a small scrollbar will appear as illustrated here. Use the scroll bar to scroll through the text. If less than 3 lines of text can be displayed, there is not enough vertical space to draw the scroll bar so an ellipsis will be drawn instead (as in the previous example) indicating that more text is available. Use the table scroll triangles in the lower right corner to scroll down the table and make more space available.

Use the TNM: menu (under the Site menu), or click the [->] button (highlighted in yellow here) to advance to the next available data page. The next page happens to be the pT page in this case. The [<-] and [->] buttons will change to reveal the adjacent pages. On handhelds that support color, the different TNM pages are color coded. Pages T and pT are tinted red. The N and pN pages are tinted green. The M and pM pages are tinted blue. The G page is tinted gold.

The following examples illustrate staging breast cancer. On the T page, check the appropriate T box, T4 was checked in this case. Click the [->] button.<

On the regional lymph nodes (N) page check the appropriate value. N0 was checked in this case. Click the [->] button twice. The first click will advance to the pN page, the button will change from [-> pN] to [-> M]. The subsequent click will advance to the distant metastasis (M) page.

On the distant metastasis (M) page check the appropriate value. M0 was checked here. Click the [->] button to continue to the histopathologic grade page or the [Stage] button.

If a histopathologic grade (G) value is required, on the "G" page check the appropriate value. Click the [Stage] button.

Clicking the [Stage] button opens the Stage Grouping form and reveals the staging. Items corresponding to the checked TNM values are highlighted. The completed stage is indicated by the row in which all columns are highlighted. This row is also inverted as illustrated here for Stage IIIB: T4N0M0. If a completed stage can be calculated, the table will automatically scroll to reveal the stage when you first enter stage grouping form. The table scroll triangles in the lower right corner reveal additional table rows of possible staging combinations. The scrollbar (seen above the table scroll triangles) in this example indicates that there is additional text associated with the ~Note. You can use this scrollbar to read the entire note. Click the "OK" button to return to the data entry pages.