Oral Cancer Staging
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Oral Cancer Staging
Making choices about your treatment and care begins with an understanding of how far the oral cancer has progressed. At Cancer Treatment Centers of America (CTCA), we believe in nurturing a collaborative environment so that you and your doctors can work together. That's why your involvement during the oral cancer staging process is so important. And that's why your CTCA care team is dedicated to clearly presenting the information you need to know during the staging process.
Oral cancer staging is an evaluation of the spread and extent of the cancer. As oral cancer develops, it may grow into the tissue, affecting movement or other functions. In advanced stages, the cancer may have metastasized (spread) to other regions or organs.
The development of oral cancer is classified by three key components: the size and extent of the Tumor, the spread to the lymph Nodes, and whether or not the cancer has Metastasized (spread) to other organs or structures. This method is known as the TNM staging system.
Oral Cancer Staging Using the TNM System
The tumors are rated on a scale from 0-4 where T0 indicates no evidence of the primary tumor expanding into local tissue, and the increasing numbers (T1-T4) correspond to the increasing size/extent of the tumor. Carcinoma in situ (Tis) describes an early cancer where the malignancy is contained within the epithelium (the top layer of cells lining the oral cavity and oropharynx) and has not grown into deeper tissue layers.
The involvement of the regional lymph nodes is rated either N1, N2, or N3 depending on the size and number of lymph nodes involved. N0 means that regional lymph nodes are cancer free. The metastases (spread) is labeled as either M0 (no sign of metastases) or M1 (the cancer has spread).
Each category (T, N and M) is assessed and rated. An X is used to denote insufficient information (the condition of the particular factor cannot be adequately assessed).
- Stage I Oral Cancer: The cancer has formed a tumor that is less than 2 cm across. The cancer has not metastasized (spread) beyond the oral cavity. (Example Grouping: T1, N0, M0)
- Stage II Oral Cancer: The tumor has now grown larger and may be 2 to 4 cm across. The cancer has not metastasized (spread) beyond the oral cavity. (Example Grouping: T2, N0, M0)
- Stage III Oral Cancer: The tumor has grown larger and may cover as much as 4 cm. The cancer may or may not have spread to a nearby lymph node. Distant sites remain unaffected. (Example Grouping: T3, N1, M0)
- Stage IV Oral Cancer: There are many types of stage IV oral cancer that are characterized by the location to which the cancer has spread and the involvement of the lymph nodes. For instance, the cancer may have spread to nearby tissues in the lip and oral cavity (stage IVA); into the muscles or bones of the oral cavity, or into base of the skull (stage IVB). In some cases, the cancer may have spread beyond the oral cavity to distant sites, such as the lungs (stage IVC). (Example Grouping: Any T, Any N, M1)
Taking the Next Steps
Treatment options may vary depending on the stage and location of the cancer. Oral cancer staging is the first step towards finding a treatment plan that's right for you. At CTCA, a team of cancer experts will support you during this process. Your team of oral cancer experts will help to provide you with a better understanding of what to expect from treatments as you prepare to take the next steps.
Next Topic: Oral Cancer Treatment
