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Number stages

There are 4 number stages of nasopharyngeal cancer. They are based on the TNM staging system. Find out what they mean.

What staging is

The stage of a cancer tells you where it is, how big it is and whether it has spread. This helps your doctor decide which treatment you need.

TNM stages

The number stages for nasopharyngeal cancer are based on the TNM stages. The letters stand for tumour, node and metastasis:

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

Number stages of nasopharyngeal cancer

There are 4 main stages of nasopharyngeal cancer, stages 1 to 4. You might also hear the term stage 0.

Stage 0 or carcinoma in situ (CIS)

Stage 0 or carcinoma in situ (CIS) nasopharyngeal cancer is a very early stage cancer. Some doctors prefer to call it pre cancer.

You might also see this stage called TIS. This stands for tumour in situ. In situ means that the cancer cells are only in the surface layer of the lining of the nasopharynx. The cells have not spread to nearby tissue, lymph nodes or anywhere else in your body.

Although the cells have not yet spread, if they are not treated, there is a high chance of them developing into an invasive cancer.

Stage 1

The cancer is in the nasopharynx and may have started to grow into the nasal cavity or oropharynx (the area at the back of the mouth and top of the throat). The cancer has not spread to nearby tissues, lymph nodes or other organs. This is the same as T1, N0, M0 in the TNM staging system.

Stage 2

Stage 2 nasopharyngeal cancer means one of the following:

  • The cancer might have spread into the oropharynx or nasal cavity, and there is cancer in the lymph nodes on one side of the neck or behind the throat. The lymph nodes are not more than 6cm across. This is the same as T1, N1, M0 in the TNM staging system.
  • The cancer has spread into the areas next to the nasopharynx (parapharyngeal space) and might have spread into the lymph nodes on one side of the neck or behind the throat. This is the same as T2, N0 or N1, M0 in the TNM staging system.

Stage 3

Stage 3 nasopharyngeal cancer means one of the following:

  • The cancer has spread to nearby bones and air cavities (sinuses). It might also have spread to lymph nodes on one or both sides of the neck, or behind the throat, but not anywhere else. The affected lymph nodes are not more than 6 cm across. This is the same as T3, N0 or N1 or N2, M0 in the TNM staging system.
  • The cancer might have spread into the oropharynx, nasal cavity or surrounding area (parapharyngeal space) and has spread into the lymph nodes on both sides of the neck. None of the lymph nodes are larger than 6cm. This is the same as T1 or T2, N2, M0 in the TNM staging system.

Stage 4

Stage 4 means the cancer is advanced. It has 3 groups.

  • 4A means the cancer has grown within the skull. It might be in the cranial (skull) nerves, eye or nearby tissues, or the lower part of the throat. There might be cancer cells in the lymph nodes on one or both sides of the neck. These nodes are smaller than 6cm and above the collarbone area. The cancer has not spread anywhere else. This is the same as T4, N0, or N1 or N2, M0 in the TNM staging system.
  • 4B means the cancer might have grown into nearby tissues or bones. It has spread to at least one lymph node that is bigger than 6cm across, or a lymph node in the collarbone area, or both. The cancer has not spread anywhere else. This is the same as any T, N3, M0 in the TNM staging system.
  • 4C means the cancer has spread to other parts of the body, such as the lungs. This is the same as any T, any N, M1 in the TNM staging system.

Recurrent nasopharyngeal cancer

You might hear the term recurrent nasopharyngeal cancer. This means nasopharyngeal cancer that has come back (recurred) after treatment. The cancer might have come back in the nasopharynx (called local recurrence) or in another part of the body.

Treatment decisions

The stage of your cancer helps your doctor to decide which treatment you need. Your treatment also depends on:

  • the type of cancer (the type of cells the cancer started in)
  • the grade of cancer (how much the cells look like normal cells)
  • where the cancer is
  • other health conditions that you have
Last reviewed: 
05 Mar 2018
  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2018

  • Textbook of uncommon cancers (4th edition)
    D Raghavan, C Blanke, D Johnson and others
    Wiley-Blackwell, 2012

  • Improving outcomes in head and neck cancers
    National Institute for Health and Care Excellence (NICE), November 2004

  • Head and Neck Cancer: multidisciplinary management guidelines
    NJ Roland and V Paleri
    London: ENT UK, 2011

  • Nasopharyngeal cancer: EHNS-ESMO-ESTRO Clinical practice guidelines for diagnosis, treatment and follow up
    ATC Chan, V Gregoire, JL Lefebvre and others 
    Annals of Oncology 23 (suppl 7) vii83-85, 2012

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