Stages of Head and Neck Cancer

Executive Summary

The head and neck cancer stages help determine the tumor’s location and metastasis. The staging system for head and neck cancer uses diagnostic tests. Thus TNM staging system helps in classifying the stages of head and neck cancer. There are five head and neck cancer stages – stages I through IV (one through four). Since, staging head and neck cancer help doctors understand how advanced the cancer condition is. knowing the stage helps understand the disease’s gravity, which allows the healthcare team to determine the treatment strategy to treat cancer. Head and neck cancer specialists and experts have developed a specific staging system for HPV-positive head and neck cancer. The initiative reflects that patients with HPV-positive head and neck tumors show a better prognosis than HPV-negative tumors.

Stages of Head and Neck Cancer

Staging is a way of describing a disease condition in terms of its gravity and location. If a person is diagnosed with a tumor, the doctor will use various diagnostic tests to determine the disease stage. Therefore, knowing the stage will help the healthcare team to understand how advanced the disease condition is and what treatment plan can be employed to treat the condition. Hence, staging can be vital in determining a patient’s survival rate after diagnosis. In the case of tumors or cancerous growth, doctors usually use a TNM staging system ^​1​. In the TNM staging system, T stands for tumor, N stands for nodes, and M stands for metastasis.

• T (Tumour): The staging system will look for the size of the tumour, how big it is and its location of origin. 

• N (Node): In terms of node, it checks whether the tumor has spread to the surrounding lymph nodes or not. If so, where and how many have been affected?

• Metastasis (M): whether the cancerous growth has metastasized or spread to different parts of the body. If so, which all body parts have been affected and to what extent? 

These results help in determining a person’s cancer or tumour stage. Usually, a cancer condition has five stages: Stage 0 (zero), Stage I, Stage II, Stage III and Stage IV. This is a common way of describing almost all types of cancers or tumour growths. So, based on these stages from 0 to 4, doctors determine the best treatment plan suiting a person’s condition. 

There is a specific staging system to describe head and neck cancer types. e.g. staging head and neck cancer help doctors understand how advanced the cancer condition is. Knowing the stage helps understand the disease gravity, which allows the healthcare team to determine the treatment strategy to treat cancer. The doctor will assign the stage of cancerous growth after a detailed physical examination and based on the diagnostic tests and scans.

The five basic stages of head and neck cancer are ^​2​: 

Stage 0 of head and neck cancer

Cancer in this stage is carcinoma in situ. Stage 0 indicates the very beginning of cancerous growth. The stage describes the abnormal cells present in the lining of the affected area that can become tumors or cancers. 

Stage I head and neck cancer

Stage I indicates a very early stage of cancer. The cancer growth may not be more than 2 centimeters. Head, and neck cancers at stage I are not seen to invade the lymph nodes.

Stage II head and neck cancer

This stage indicates a tumour growth larger than 2 centimeters but not more than 4 centimeters. At this stage, the cancerous growth is not seen to invade the lymph nodes.

Stage III head and neck cancer

This stage indicates a more aggressive stage of head and neck cancers. Stage III cancers are usually larger than 4 centimeters.

Stage IV head and neck cancer

This indicates the most advanced stage of head and neck cancer. The tumour portrays large-scale metastasis. So, this can spread to nearby tissue or organs. It can invade one large lymph node, which is larger than 3 centimeters, present on the same side of the neck region as the tumour mass, or it can affect multiple lymph nodes of any size on the same side of the neck as the tumour. It can even invade lymph node(s) on the side of the neck region opposite to the tumour growth. These tumors can even metastasize to distant body parts beyond the neck and head region and invade vital organs like the lungs or heart. 

There are cases where head and neck cancers are diagnosed at stage IV. These cancers can also be recurrent. So, recurrent cancer refers to tumour growths that can return in the body, even after successful treatment. Soon it can recur in the same spot as in the initial case, called a regional recurrence, in the surrounding lymph nodes called a regional relapse, or in any distant part of the body called a distant recurrence.

Stage II and Stage IV head and neck cancers are more likely to come back in the body after treatment. on the contrary, cancers of other stages are less likely to recur in the body.

Recurrent head and neck cancer

Recurrent cancer refers to a cancerous growth that recurs or comes back in the body after successful treatment. If the tumour growth recurs in the body, another set of scans and tests helps to learn about the gravity of the disease and the extent of the recurrence. The doctor will recommend diagnostic procedures that may or may not be the same as those prescribed during cancer’s initial management and treatment.

Staging for HPV-Positive Head and Neck Cancer

Head and neck cancer specialists and experts have developed a specific staging system for HPV-positive head and neck cancer. The initiative reflects that patients with HPV-positive head and neck tumors show a better prognosis than HPV-negative tumors.

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