English
Spanish
French
German
Dutch
Swedish
Stages of Throat Cancer
Definition of Staging
Staging is the process of finding out how far a cancer has spread. The outlook (prognosis) for people with cancer depends, to a large extent, on the cancer's stage. The stage of throat cancer is one of the most important factors in choosing treatment.
General Information on Staging
Staging is based on knowledge of how cancer develops. Cancer cells divide and grow to form a mass of tissue called a tumor. As the tumor grows, it can invade nearby organs and tissues. Cancer cells may also break away from the tumor and enter the bloodstream or lymphatic system. By moving through the bloodstream or lymphatic system, cancer can spread from the primary site to form new tumors in other organs. The spread of cancer is called metastasis.2 Staging information is based on the results of the physical exam, endoscopy, and imaging tests (CT scan, MRI, chest x-ray, and/or PET scans).
Purpose of Cancer Staging
Staging helps the cancer diagnosis and treatment process in several important ways.
- Staging helps doctors to plan the patient's appropriate treatment.
- The stage can be used to estimate the person's prognosis (likely outcome or course of the disease).
- Knowing the stage helps to identify clinical trials that may be suitable for a patient.2
Staging also helps researchers and health care providers to exchange information about the patient, provide a common language for diagnosis, treatment and clinical trials.
Tests to Determine Throat Cancer Stage
Tests used for staging depend on the type of cancer and may include:
Physical Exams
Physical exams are used to gather information about the cancer. The doctor examines the body by looking, feeling, and listening for anything unusual. The physical exam may show the location and size of the tumor(s) and the spread of the cancer to the lymph nodes and/or other organs.
Imaging Studies
Imaging studies produce pictures of areas inside the body. These studies are important tools in determining stage. Procedures such as x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and positron emission tomography (PET) scans can show the location of the cancer, size of the tumor, and whether the cancer has spread.
Laboratory Tests
Laboratory tests are studies of blood, urine, other fluids, and tissues taken from the body. For example, tests for liver function and tumor markers (substances sometimes found in increased amounts if cancer is present) can provide information about the cancer.
Pathology Reports
Pathology reports may include information about the size of the tumor, growth of the tumor into other tissues and organs, type of cancer cells, and grade of the tumor (how closely the cancer cells resemble normal tissue). A biopsy (the removal of cells or tissues for examination under a microscope) may be performed to provide information for the pathology report. Cytology reports also describe findings from the examination of cells in body fluids.
Surgical Reports
Surgical reports tell what is found during surgery. These reports describe the size and appearance of the tumor and often include observations about lymph nodes and nearby organs.
Stage Throat Cancer Using the TNM System
While there are different staging systems for different cancers, the most widely used system in the United States is called the TNM System. It is also known as the Staging System of the American Joint Committee on Cancer.1
For many cancers, TNM combinations correspond to one of five stages as shown below.1 Criteria for stages differ for different types of cancer.
Stage |
Definition |
Stage 0 |
Cancer is in situ (early cancer that is present only in the layer of cells in which it began). |
Stage I, Stage II, and Stage III |
Higher numbers indicate more extensive disease: greater tumor size, and/or spread of the cancer to nearby lymph nodes and/or organs adjacent to the primary tumor. |
Stage IV |
The cancer has spread to another organ. |
The TNM System describes the extent of the primary tumor (T stage), whether the cancer has spread to nearby lymph nodes (N stage), and whether the cancer has spread to other parts of the body (M stage). There are 4 categories for describing the cancerous tumor's (T) stage, ranging from T1 to T4.
Once the T, N, and M categories have been assigned, this information is combined by a process called stage grouping to assign an overall stage of 0, I, II, III, or IV. Stage IV is further divided into A, B, and C.
Stage 0: Tis, N0, M0
Carcinoma in situ. The cancer is only growing in the epithelium, the outer layer of oral or oropharyngeal tissue (Tis). It has not yet grown into a deeper layer or spread to nearby structures, lymph nodes (N0), or distant sites (M0).
Stage I: T1, N0, M0
The tumor is 2 cm (about ¾ inch) across or smaller (T1) and has not spread to nearby structures, lymph nodes (N0), or distant sites (M0).
Stage II: T2, N0, M0
The tumor is larger than 2 cm across but smaller than 4 cm (T2) and has not spread to nearby structures, lymph nodes (N0), or distant sites (M0).
Stage III
One of the following applies:
T3, N0, M0
The tumor is larger than 4 cm across, but it hasn't grown into nearby structures or spread to the lymph nodes (N0) or distant sites (M0).
OR
T1 to T3, N1, M0
The tumor is any size and hasn't grown into nearby structures (T1 to T3). It has spread to one lymph node on the same side of the head or neck, which is smaller than 3 cm across (N1). The cancer hasn't spread to distant sites (M0).
Stage IVA
One of the following applies:
T4a, N0 or N1, M0:
The tumor is growing into nearby structures (T4a). It can be any size. It has either not spread to the lymph nodes (N0) or has spread to one lymph node, on the same side of the head or neck, which is smaller than 3 cm across (N1). The cancer hasn't spread to distant sites (M0).
OR
T1 to T4a, N2, M0
The tumor is any size and may or may not invade nearby structures. It has not spread to distant sites (M0). It has spread to one of the following:
- one lymph node one the same side of the head and neck that is between 3 and 6 cm across (N2a)
- one lymph node on the opposite side of the head and neck that is less than 6 cm across (N2b)
- 2 or more lymph nodes, all of which are smaller than 6 cm across. The lymph nodes can be on any side of the neck (N2c)
Stage IVB
One of the following applies:
T4b, any N, M0
The tumor is growing into deeper areas and/or tissues (very advanced local disease - T4b). It may (or may not) have spread to lymph nodes (any N). It has not spread to distant sites (M0).
OR
Any T, N3, M0
The tumor is any size and it may or may not have grown into other structures (any T). It has spread to one or more lymph nodes larger than 6 cm across (N3), but it hasn't spread to distant sites (M0).
Stage IVC
Any T, Any N, M1: The tumor is any size, and it may or may not have spread to lymph nodes. It has spread to distant sites, most commonly the lungs.
Recurrent (relapsed) cancer
This is not an actual stage in the TNM system. Recurrent (relapsed) disease means that the cancer has come back (recurred) after treatment. Recurrent oral cavity or oropharyngeal cancer may return in the mouth or throat (local recurrence), in the lymph nodes (regional relapse) or in another part of the body (distant recurrence, usually in the lungs).
Talk with your doctor, if you have any questions about the stage of your cancer or how it affects your treatment.
Learn More
Learn more about treatment options for throat cancer.
- National Cancer Institute; Staging: Questions and Answers. Available from: http://www.cancer.gov/cancertopics/factsheet/Detection/staging
- American Cancer Society; “How Are Oral Cavity and Oropharyngeal Cancers Staged? Available from: http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_oral_cavity_and_oropharyngeal_ cancer_staged_60.asp?sitearea
While clinical studies support the effectiveness of the da Vinci Surgical System when used in minimally invasive surgery, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Surgery with the da Vinci Surgical System may not be appropriate for every individual; it may not be applicable to your condition. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine whether da Vinci Surgery is appropriate for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctor about da Vinci Surgery are not necessarily those of Intuitive Surgical, Inc. and should not be considered as substitute for medical advice provided by your doctor. All people depicted unless otherwise noted are models. © 2012 Intuitive Surgical. All rights reserved. Intuitive, Intuitive Surgical, da Vinci, da Vinci S, da Vinci Si, Single-Site, InSite, TilePro and EndoWrist are trademarks or registered trademarks of Intuitive Surgical. All other product names are trademarks or registered trademarks of their respective holders.
