Decorative image

Stage 4

Find out what stage 4 oesophageal cancer means and about treatment options.

The stage of a cancer tells you how big it is and how far it’s spread. It helps your doctor decide which treatment you need.

Stage 4 means that your cancer is advanced and has spread to other parts of the body, such as your liver or lungs.


TNM stages

The TNM staging system stands for Tumour, Node, 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

In the TNM staging system stage 4 is the same as Any T, Any N, M1.


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

  • your type of cancer (the type of cells the cancer started in)
  • where the cancer is 
  • other health conditions that you have

You may have either

  • chemotherapy
  • radiotherapy
  • symptom control eg. treatment to help you swallow food
  • trastuzumab (Herceptin) biological therapy if your cancer is in the gastro oesophageal junction area and has HER2 protein on the cells

Other stages

Last reviewed: 
06 Jul 2016
  • AJCC Cancer Staging Manual (7th edition)
    American Joint Committee on Cancer, Springer, 2010

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser D
    Wiley-Blackwell, 2014

  • ESMO, oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    Ann Oncol. 2013 Oct;24 Suppl 6:vi51-6.

  • Principles and practice of oncology (9th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2011

  • TNM Classification of Malignant Tumours (7th edition) International Union Against Cancer
    LH Sobin, MK Gospodarowicz, CH Wittekind
    John Wiley and Sons, Hoboken, New Jersey, 2009

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.