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Stages of salivary gland cancer

Men and women discussing salivary gland cancer

This page tells you about the stages of salivary gland cancer. There is information about

 

A quick guide to what’s on this page

The stages of salivary gland cancer

The stage of a cancer means how big it is, and whether it has spread. The tests and scans you have to diagnose your cancer give some information about the stage. This is important as your specialist uses this information to decide about the most suitable treatment for you.

Different staging systems

The TNM staging system for salivary gland cancer includes detailed information about the size of the tumour (T), whether there is cancer in the lymph nodes (N) and whether the cancer has spread to anywhere else in the body – metastases (M). The doctor gives each aspect a number. So a small cancer that hasn’t spread is T1, N0, M0. A cancer that is larger and has spread may be T3, N1, M1.

The number staging system uses information from the TNM staging system to divide salivary gland cancers into one of 4 groups – stages 1 to 4.

The grade of salivary gland cancer

The grade of a cancer is a guide to how fast it is likely to grow. A low grade tumour is generally slow growing and high grade tumours are generally faster growing.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating salivary gland cancer section.

 

 

What staging and grading is

The stage of a cancer tells the doctor how far it has grown or spread. This is important, as your specialist uses this information to decide on the most suitable treatment for you. The tests and scans you have when diagnosing your cancer give your doctor some information about the stage.

The grade of a cancer is a guide to how fast it is likely to grow. A low grade tumour is generally slow growing and high grade tumours are generally faster growing.

 

Different salivary gland cancer staging systems

There are different ways of staging cancers. The two main ways are the TNM system and number system.

The information you get about the stage of your cancer may sound a bit confusing. You may not be familiar with the terms your doctor uses. If you don't understand what stage your cancer is, and would like to know more, ask your doctor or specialist nurse.

Knowing the stage of your cancer may help you understand why your doctors have chosen a particular treatment for you. At the end of this section there is a list of questions for your doctor that may help. There is more about staging cancers in the section about cancer.

 

TNM staging system

TNM stands for Tumour, Node and Metastasis. The system describes

T stages of salivary gland cancer

  • T1 means the tumour is all inside the tissue of the salivary gland and is smaller than 2cm across (about ¾ inch across)
  • T2 – the tumour is larger than 2cm, but smaller than 4cm across (about 1 ½ inches)
  • T3 – the tumour is bigger than 4cm and/or it has spread into the soft tissues around the salivary gland
  • T4a – the tumour has grown outside the salivary gland into nearby body tissues such as the jaw, ear canal, facial nerves or skin
  • T4b – the tumour has grown into the bottom of the skull, or the side of the skull, or covers the main blood vessel called the carotid artery

N stages of salivary gland cancer

  • N0 – there are no cancer cells in the lymph nodes
  • N1 – there are cancer cells in one lymph node on the same side as the affected salivary gland and the lymph node is smaller than 3cm in size
  • N2 is divided into 3 sub groups
    • N2a – there are cancer cells in one node on the same side as the affected salivary gland and the lymph node is between 3 and 6cm in size (between 1.2 and 2.4 inches)
    • N2b – there are cancer cells in several lymph nodes on the same side as the affected salivary gland and the lymph nodes are all smaller than 6cm in size
    • N2c – there are cancer cells in the lymph nodes on the other side of the face or in lymph nodes on both sides and the lymph nodes are all smaller than 6cm
  • N3 – There are cancer cells in at least one lymph node which is bigger than 6cm in size

The M stages (metastasis)

M0 means there is no sign of cancer spread
M1 means the cancer has spread to other parts of the body further away, such as the lungs

 

The number staging system

There are 4 main number stages of salivary gland cancer.

Stage 1 means that the tumour is only in the salivary gland and is smaller than 2cm.

Stage 2 means that the tumour is only in the salivary gland and is between 2 and 4 cm.

Stage 3 means that either

  • The tumour is smaller than 4cm, and there is cancer in one lymph node on the same side that is smaller than 3cm across
  • The tumour is bigger than 4cm and may have spread to the soft tissues around the salivary gland. It may also have spread to a lymph node on the same side but the node is smaller than 3cm across

Stage 4 means that the cancer is advanced and there are 3 groups within stage 4 salivary gland cancer.

Stage 4a means that the cancer has grown into the tissues around the salivary gland, the skin, the jawbone, ear canal or facial nerve. And there are cancer cells in the lymph nodes on one or both sides of the neck. These lymph nodes are smaller than 6cm across (2.4 inches).

Stage 4b means that the cancer has grown into the tissues around the salivary gland, the base of the skull or the main blood vessel in the neck (the carotid artery). There are cancer cells in the lymph nodes on one or both sides of the neck and at least one lymph node is larger than 6cm across.

Stage 4c means that the cancer has spread to another part of the body, such as the lungs.

 

Grades of salivary gland cancer

The grade of the cancer tells you how like normal cells the cancer cells look. There are 3 grades.

Grade 1 cancer (low grade) means the cancer cells look very like normal salivary gland cells.

Grade 2 cancer (intermediate grade) means the cancer cells look slightly like normal salivary gland cells.

Grade 3 cancer (high grade) means the cancer cells look very abnormal and unlike normal salivary gland cells.

Differentiation means how developed or mature a cell is. So you may hear your doctor describe grade 1 cancer cells as well differentiated. Grade 2 cancer cells are moderately differentiated. Grade 3 cancer cells are poorly differentiated.

The grade also gives an idea of how fast growing a cancer is and whether it is likely to spread. Low grade cancers maybe slower growing and less likely to spread. High grade cancers tend to be faster growing and more likely to spread.

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Updated: 24 June 2014