Stage
The stage of a cancer is determined by the TNM staging system:
- The ‘T’ stands for tumor size.
- The ‘N’ stands for lymph node involvement.
- The ‘M’ stands for distant metastases, or cancer spread to other areas of the body.
Staging helps doctors determine how serious the cancer is and how best to treat it.
Staging systems often reference very specific anatomical structures. Please reference the anatomy page to learn more about these terms.
Staging for metastatic lymph nodes is based on the type of cancer of the primary tumor. Please visit the “Determining Type, Grade & Stage” page for the specific primary tumor type found within the metastatic lymph node for more information on individual staging systems. General information regarding cancer staging can be found below.
Two Staging Systems: Clinical & Pathological
- Clinical Stage
Once the diagnostic tests are completed, a clinical stage can be determined based on physical exam findings, imaging studies, and biopsy results. - Pathologic Stage
Pathologic stage can only be determined if surgery is performed. Unlike the clinical stage determined prior to surgery, pathologic stage is based on a full analysis of the entire tumor and removed lymph nodes under a microscope by a pathologist. In many cases, the pathologic stage will be the same as the clinical stage, but sometimes it will change. The pathologic stage can be considered to be a more accurate assessment of cancer stage.
T Stage: the Main Tumor Mass
The T stage pertains to the main tumor mass. The main tumor, also called the primary tumor, is the first tumor that formed. Based on a physical examination and review of any imaging, a doctor should be able to provide a T stage:
- If the primary cancer cannot be found, the tumor is referred to as Tx. This is also called cancer with an unknown primary, or CUP.
- If a primary cancer site is known, the T stage will be assigned based on the specific staging system of the primary cancer.
N Stage: Spread of Cancer to the Lymph Nodes in the Neck
A doctor will use all of the information available to assign an N stage based on whether the cancer has spread to lymph nodes in the neck.
M Stage: Spread of Cancer Outside the Head & Neck
Based on assessments of the entire body, an M stage will be assigned. This is based on whether the cancer has spread to other parts of the body, and if so, how far it has spread.
