Pharyngeal Cancer Staging
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Pharyngeal Cancer Staging
A clinical evaluation of symptoms, such as trouble swallowing (dysphagia), coughing or a persistent sore throat may lead to the diagnosis of pharyngeal cancer. If cancer is found, a variety of imaging tests, like x-rays, magnetic resonance imaging (MRI), computerized tomography (CT) or positron emission tomography (PET) scans may be used to determine the location and spread of the cancer.
Pharyngeal cancer staging is a process that, using the information from the clinical evaluation and additional tests, summarizes the spread and extent of the cancer in stages labeled with Roman numerals, I-IV. Sometimes stage 0 is used to indicate that the cancer is "in situ." This occurs when the cancerous cells are localized to one site and have not spread.
Understanding the TNM System
Pharyngeal cancer stages are defined by three key components, according to the American Joint Committee on Cancer (AJCC) TNM system:
Tumor - The tumors are rated on a scale where T0 indicates no evidence of the primary tumor expanding into local tissue, and the increasing numbers (T1, T2, T3, T4) correspond to the increasing size/extent of the tumor.
Node - The staging process evaluates the involvement of the regional lymph nodes on a scale where N0 indicates no regional lymph node involvement. The increasing numbers (N1, N2, N3) are related to the spread (distance from original site) and the number of lymph nodes involved. The greater the distance, or number of lymph nodes involved, the higher the number.
Metastasized - 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).
Understanding Pharyngeal Cancer Staging
In general, Roman numerals I through IV are used to indicate the stage of head and neck cancer. Carcinoma in situ (stage 0) and stage I are often characterized by small tumors that have remained localized to their point of origin and have not spread or invaded nearby tissue or organs. In advanced stages, like stage IV, the cancer has metastasized to other parts of the body.
The staging of pharyngeal cancer is specific to the part of the pharynx involved. For example, stages of nasopharyngeal cancer may take into account the extent of the cancer into the soft tissues of the nasal cavity or the oropharynx, whereas hypopharyngeal cancer staging may consider the affect the tumor has on the vocal cords.
General Stage Groupings for Pharyngeal Cancer
- Stage I Pharyngeal Cancer: The tumor is limited to one region of the pharynx (nasopharynx, oropharynx or hypopharynx); tumors in oropharynx or hypopharynx are smaller than a peanut (2 cm). The cancer has not spread (M0) beyond its origin.(Example: T1, N0, M0)
- Stage II Pharyngeal Cancer: The cancer may have grown into another region of the pharynx or nearby soft tissues, or the cancer may have spread into nearby lymph nodes. The cancer has not spread (M0) to distant sites.(Example: T2, N0, M0)
- Stage III Pharyngeal Cancer: The cancer has grown beyond the site of origin and may have spread into nearby soft tissues or lymph nodes.(Example: T3, N1, M0)
- Stage IV Pharyngeal Cancer: The cancer may be any size and has spread throughout the body.(Example: Any T, Any N, M1)
Taking the Next Steps
Understanding where and how the cancer has spread is important when it comes to selecting treatment options. At CTCA, we understand that cancer treatment affects the whole body and so we offer a variety of conventional treatments alongside complementary therapies that support the body, mind and spirit. Staging is the first step towards finding a treatment plan that's right for you.
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