Once your doctor has diagnosed cancer, it important to find out how big the cancer is and where it started to grow. They need to see if the cancer has spread to the lymph nodes in the neck (nodal metastases) or other parts of the body such as the lungs, liver or bone (distant metastases). The term used to describe where the cancer has started to grow is called ‘primary’ and if it spreads to other parts of the body, it is called a ‘secondary’ or ‘metastases’. This is called staging. Staging a cancer is important because it helps your doctor to choose the best treatment for you.
Once the values for T, N and M have been worked out, they are combined to give an overall score between 1 and 4. Your doctor may write these as Roman numerals: I (1), II (2), III (3) and IV (4). The staging is complicated but cancers may be described as:
Early cancer: these are Stage I or II cancers which are small (less than 4cm in size) that have not spread.
Advanced cancer: Stage III or IV cancers are bigger (more than 4cm), have grown into nearby tissue, spread to lymph nodes, or spread to other parts of the body.
It is important to know that the staging systems for head and neck cancer are not very good at predicting the chances of cure for one person. For example, Stage III (3) or IV (4) cancers may include many groups of people where the chances of cure are very good but also others where the cancer may not be curable. It is important you discuss the stage of your cancer with your doctors to understand what it means for you.
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