Head and neck cancer is classified into stages to indicate how large the cancer is and how far it has spread.
Throat Cancer
Throat cancer is classified into five stages, with stage IV being the most advanced.
- Stage 0: Abnormal cells that may lead to cancer are found in the throat, voice box, or tonsils. This stage is also called carcinoma in situ.
- Stage I: Actual cancer is found in the larynx only, which can include the throat, voice box, or vocal cords. The vocal cords can still move normally.
- Stage II: Cancer is still limited to the larynx only, but the vocal cords may not move normally.
- Stage III: Cancer may have spread to lymph nodes near the neck or to tissues near the neck. If cancer is confined to the larynx, the vocal cords cannot move.
- Stage IV: Cancer has spread to tissues outside the larynx, such as the thyroid cartilage, the neck, or the esophagus, or it may have spread to distant areas of the body, such as the lungs or liver.
Oral Cancer
- Stage 0: Abnormal cells are seen in the lining of the lips or oral cavity. These cells may develop into cancer. This stage is also called carcinoma in situ.
- Stage I: Actual cancer has formed, but the tumor is small and has not spread to lymph nodes.
- Stage II: The tumor is larger (between two and four centimeters), but it has not spread to any lymph nodes.
- Stage III: The tumor can be of any size and has spread to one lymph node on the same side of the neck in which the cancer began, or the tumor is larger than four centimeters.
- Stage IV: The cancer has spread through the lip and oral cavity to nearby tissues such as the jaw, the tongue, the floor of the mouth, the sinuses in the cheek area next to the nose, or the skin on the chin or nose.
Sinus and Nasal Cavity Cancers
Some cancers of the sinus, such as cancer of the sphenoid sinuses (in the back of the skull) and frontal sinuses (near the forehead), have no standard staging system.
Cancers of other parts of the sinuses are staged as follows:
Maxillary sinuses
Maxillary sinuses are in the cheek area next to the nose.
- Stage 0: Abnormal cells are found in the inner lining of the maxillary sinus. These cells may develop into cancer. This stage is also called carcinoma in situ.
- Stage I: Actual cancer has formed in the mucous lining of the maxillary sinus.
- Stage II: Cancer has spread to bone around the maxillary sinus, which includes the roof of the mouth and the nose. Cancer has not spread to bone at the back of the maxillary sinus or the base of the skull.
- Stage III: Cancer may have spread to bone at the back of the maxillary sinus, to the eye socket, to tissues under the skin, to the base of the skull, or to sinuses in the upper part of the nose near the eyes (the ethmoid sinuses). Cancer may have spread to a lymph node on the same side of the neck where the cancer began.
- Stage IV: Cancer has spread to one or more lymph nodes. It may also have spread to areas far away from where the cancer started, such as the back of the eye, the brain, or the lungs.
Nasal cavity and ethmoid sinuses
These are the sinuses at the top of the nose near the eyes.
- Stage 0: Abnormal cells are found in the inner lining of the nasal cavity or the ethmoid sinuses. These cells may develop into cancer. This stage is also called carcinoma in situ.
- Stage I: Actual cancer has developed. It is found in only one area -- either the nasal cavity or the sinuses in the upper part of the nose near the eyes). It may have spread into bone.
- Stage II: Cancer is found in both the areas (the nasal cavity and the ethmoid sinus). It may or may not have spread to bone.
- Stage III: Cancer may have spread to a lymph node on the same side of the neck as the original cancer. It has also spread to areas adjacent to the nasal cavity, such as the eye socket, the roof of the mouth, the maxillary sinus, or the bone between the eyes.
- Stage IV: Cancer has spread to one or more lymph nodes and has spread to more distant areas, such as the front of the nose and cheeks, the base of the skull, the back of the eye, or the brain.
Metastatic Squamous Neck Cancer With Occult Primary
There is no standard staging system for metastatic squamous neck cancer with occult primary. Instead, the tumors are described as being in one of two categories:
- Untreated: The cancer has been diagnosed but not treated except to relieve symptoms
- Recurrent: The cancer has returned after treatment. The cancer may have come back in the neck or in other areas of the body
Learn more about head and neck cancer:
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