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Stage and grade for nasal cavity cancer

Men and women discussing nasal and sinus cancer

This page has information on staging and grading nasal cavity cancer. You can find the following

 

A quick guide to what's on this page

Stage and grade for nasal cavity cancer

The stage of a cancer tells the doctor how far it has spread. It is important because treatment is often decided according to the stage of a cancer. The staging of nasal cavity cancer is complicated. 

TNM staging

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

  • The size of a primary tumour (T) and how far it’s grown locally
  • Whether the cancer has spread to the lymph nodes (N)
  • Whether the cancer has spread to a different part of the body (M)

Number stages

There are 5 main stages in this system – stages 0 to 4. Stage 0 a very early stage cancer. Some doctors prefer to call this pre cancer because there are cancer cells only in the skin like covering of your nasal cavity. This means the cancer cells are contained there and cannot spread. If it is not treated, there is a high chance of this condition going on to develop into an invasive cancer. Stage 1 is the earliest stage of invasive cancer. Stage 4 means the cancer is advanced.

Grade

The grade of a cancer tells you how much the cancer cells look like normal cells. There are 3 grades of nasal cavity cancer. Grade 1 is low grade. This means the cancer cells look very much like the normal nasal cavity cells. Grade 2 is intermediate grade. And grade 3 is high grade, meaning the cancer cells look very abnormal. Low grade cancers are usually slower growing and less likely to spread. High grade cancers are likely to be faster growing and are more likely to spread.
 

CR PDF Icon You can view and print the quick guides for all the pages in the treating nasal cancer section.

 

 

What staging is

The stage of a cancer tells the doctor how far a cancer has grown or spread. It is very important because the stage often decides the treatment. The tests and scans that you have when your doctor is diagnosing your cancer will give you some information about the stage. But your doctor may not be able to tell you the exact stage until after you have surgery.

 

What TNM staging means

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

  • The size of a primary tumour (T)
  • Whether the cancer has spread to the lymph nodes (N)
  • Whether the cancer has spread to a different part of the body (M)
 

TNM stages of nasal cavity cancer

T stages

There are 4 T stages of nasal cancer

  • T1 means the tumour is only in one part of the nasal cavity, but it may have grown into the bones of the nasal cavity

    Diagram showing stage T1 nasal cavity cancer
  • T2 means the tumour has begun to grow into other nasal or paranasal cavities

    Diagram showing stage T2 nasal cavity cancer
  • T3 means the tumour has spread into the bone of the eye socket, palate or maxillary sinus

    Diagram showing stage T3 nasal cavity cancer
  • T4 means the tumour has spread into other nearby structures such as the eye, skull, brain, skin of the nose or cheek, sphenoid or frontal sinuses or nearby nerves


Diagram showing stage T4 nasal cavity cancer

N stages

There are 4 main lymph node stages in cancer of the nasal cavity, although N2 is divided into 3 parts - 2a, 2b and 2c. The important points here are whether there is cancer in any of the lymph nodes, and if so, how big they are and where they are

  • N0 means there are no lymph nodes containing cancer cells
  • N1 means there are cancer cells in one lymph node on the same side of the neck as the tumour, but the node measures 3cm across or less
  • N2a means there is cancer in one lymph node, on the same side of the neck, that is more than 3cm across but no more than 6cm
  • N2b means there is cancer in more than one lymph node on the same side of the neck, but none of them are more than 6cm across
  • N2c means there is cancer in lymph nodes on the other side of the neck (or on both sides) but none are more than 6cm across
  • N3 means that one or more nodes contain cancer and at least one node is more than 6cm across

Diagram showing nasal cavity cancer that has spread to the lymph nodes

M stages

There are 2 stages to describe spread of cancer of the nasal cavity to other parts of the body

  • M0 means there is no cancer spread to other parts of the body
  • M1 means the cancer has spread to other parts of the body, such as the lungs, brain or liver

Diagram showing nasal cavity cancer that has spread to the lungs

Together, the T, N and M stages give a complete description of the stage of your cancer. For example, if you have a T2, N0, M0 cancer of the nasal cavity, you have a tumour that has begun to grow into other parts of the nasal cavity, the lymph nodes are clear and there is no spread of your cancer to other parts of the body.

 

Number stages for nasal cavity cancer

There are 5 number stages of nasal cavity cancer.

Stage 0 or carcinoma in situ (CIS)

If you have CIS or stage 0 cancer, you have a very early stage cancer. Some doctors prefer to call this pre cancer because there are cancer cells only in the skin like covering of your nasal cavity. This means the cancer cells are contained there and cannot spread. As the cells cannot spread, this is not yet a true cancer. If the pre cancer is not treated, there is a high chance of this condition going on to develop into an invasive cancer.

Stage 1

If you have stage 1 cancer of the nasal cavity, it means the cancer has not spread. But it may have grown into the bones surrounding the nasal cavity. The cancer has not spread to the lymph nodes or other parts of the body.

Stage 2

If you have stage 2 cancer of the nasal cavity, it means the cancer is in more than one part of the nasal cavity, or has spread to surrounding tissues. The cancer has not spread to the lymph nodes or other parts of the body.

Stage 3

Having stage 3 cancer of the nasal cavity can mean one of 2 things

  • The cancer has begun to grow into the bones of the eye socket, the floor of the maxillary sinus (hard palate), or both. It has not spread to the lymph nodes or other organs.
  • The tumour is any size, except T4, and has spread to one lymph node on the same side of the neck, which is no more than 3cm across

Stage 4

This means the cancer is advanced. All T4 tumours are considered to be stage 4 even if they have not spread to lymph nodes or other parts of the body. Stage 4 could mean one of 3 things

  • The tumour has grown into other nearby structures such as the eye, skull, sphenoid or frontal sinuses, or skin of the nose or cheek
  • The cancer is any size and has spread to more than one lymph node bigger than 3cm on the same side of the neck, or has spread to more than one lymph node of any size on one or both sides of the neck
  • The cancer has spread to other parts of the body such as the lungs, liver or brain
 

Grading nasal cavity cancer

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

  • Grade 1 (low grade) - the cancer cells look very much like the normal nasal cavity cells
  • Grade 2 (intermediate grade) - the cancer cells look slightly like normal nasal cavity cells
  • Grade 3 (high grade) - the cancer cells look very abnormal and very little like normal nasal cavity cells

The word 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 of the cancer gives your specialist a guide as to how the cancer is likely to behave. Low grade cancers are usually slower growing and less likely to spread. High grade cancers are likely to be faster growing and are more likely to spread. This is only a guide. Your specialist will consider all your test results when deciding which treatment is best for you.

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Updated: 31 July 2014