Nasopharyngeal cancer

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Stages of nasopharyngeal cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for nasopharyngeal cancer is the TNM system. For nasopharyngeal cancer there are 5 stages – stage 0 followed by stages 1 to 4. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the larger the cancer is or the more the cancer has spread. Talk to your doctor if you have questions about staging.

Location of the Pharynx

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the nasopharynx and has not spread to other parts of the body. Regional means close to the nasopharynx or around it, such as the lymph nodes in the neck. Distant means in a part of the body farther from the nasopharynx.

Find out more about staging cancer.

Stage 0 (carcinoma in situ)

The tumour is only in the lining of the nasopharynx.

Stage 1

The tumour is only in the nasopharynx or it may have grown into the oropharynx or nasal cavity or both.

Stage 2

The tumour has grown into the space around the pharynx or nearby muscles or both.

OR

The cancer has spread to any of the following lymph nodes above the level of the larynx and they are not larger than 6 cm:

  • 1 lymph node in the neck (cervical lymph node)
  • lymph nodes behind the pharynx (retropharyngeal lymph nodes) on 1 or both sides of the neck

Stage 3

The tumour may have grown into any of the following:

  • oropharynx
  • nasal cavity
  • the space around the pharynx
  • nearby muscles
  • the nearby bones of the skull
  • the part of the spine within the neck
  • the air-filled cavities around the nose within the skull (paranasal sinuses)

The cancer may also have spread to lymph nodes in the neck or behind the pharynx above the level of the larynx and they are not larger than 6 cm.

Stage 4A

The tumour has grown into any of the following:

  • the inside of the skull
  • any of the 12 pairs of cranial nerves (the nerves that control many functions in the head and neck, such as swallowing, vision, smell, hearing and eye movement)
  • hypopharynx
  • eye socket (orbit)
  • parotid gland
  • through the outer part of the lateral pterygoid muscle (a muscle that helps you chew food)

The cancer may also have spread to lymph nodes in the neck or behind the pharynx above the level of the larynx and they are not larger than 6 cm.

Stage 4B

The cancer has spread to lymph nodes in the neck and they are larger than 6 cm or there are lymph nodes with cancer that are below the level of the larynx or both.

Stage 4C

The cancer has spread to other parts of the body (called distant metastasis), such as to the lungs, the liver or other bones. This is also called metastatic nasopharyngeal cancer.

Recurrent nasopharyngeal cancer

Recurrent nasopharyngeal cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

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