Salivary gland cancer
The stage of salivary gland cancer tells you how big it is, its depth and whether it has spread. It helps your doctor plan the best treatment for you. They may use the TNM system or a number staging system.
TNM stands for Tumour, Node, Metastasis. The system describes:
the size of the cancer (tumour)
whether the cancer has spread to the
whether the cancer has spread to a different part of the body
The staging system for salivary gland cancer includes the major and minor salivary glands. Salivary gland cancer most commonly starts in the head and neck. Rarely, it can also start in other sites, such as the breast or windpipe (trachea).
Find out more about the salivary glands
There are different ways to find out your stage. Your doctor might use:
clinical staging before treatment and if you don't have surgery
pathological staging if you do have surgery
This means your doctor stages the cancer after examining you and looking at your blood test, biopsy and scan results. Doctors use clinical staging to plan your treatment. It’s also the best way to stage people who aren’t having surgery. You might see your clinical stage written as cTNM.
This means your doctor stages the cancer after examining the tissue that the surgeon removes during an operation. This is also called surgical staging. Your doctor combines your clinical stage results with the surgical results.
Pathological staging is generally a more precise way to find out how big your cancer is, how quickly the cells are likey to grow and how far it has spread. Your pathological stage might be different to your clinical stage. You might see your pathological stage written as pTNM. Pathological staging can help your doctor decide if you need further treatment.
Cancer staging is complicated. If you need help understanding it, ask your doctor or specialist nurse to explain it to you.
We describe the pathological TNM staging below.
T describes the size of the cancer (tumour).
This means carcinoma in situ. The cancer cells are only in the lining of one of the salivary ducts or small sacs within the salivary glands. Salivary ducts are small tubes that carry saliva from the salivary glands to the mouth.
This means the cancer is within the tissue of the salivary gland and is 2cm or smaller.
This means the cancer is more than 2cm but no larger than 4cm.
This means the cancer is bigger than 4cm, or it is any size and has spread into nearby soft tissues or a nerve.
T4 is divided into 2 groups:
T4a means the cancer has grown outside the salivary gland into nearby tissues or structures. This includes the skin, jawbone, cartilage, the food pipe (oesophagus), windpipe (trachea) or facial nerves.
T4b means the cancer has grown further than the nearby tissues and structures. This includes the large blood vessel called the carotid artery, the base of the skull, the spine or areas of the head including the eye socket, muscles used for chewing or the brain.
N refers to your lymph nodes. These are a network of glands throughout the body, for example, in your armpits and neck. They drain away waste fluid, waste products and damaged cells, and contain cells that fight infection.
When looking at your lymph nodes, your doctor keeps the following in mind:
whether any nodes contain cancer
the size of the node containing cancer
which side of the neck the node containing cancer is in
This means there are no cancer cells in the lymph nodes.
This means the cancer is in 1 to 3 lymph nodes
This means the cancer is in more than 3 lymph nodes. Or the cancer is in any number of lymph nodes and has grown into the surrounding tissues.
This tells you whether the cancer has spread to a different part of the body.
This means the cancer has spread to other parts of the body further away, such as the liver.
Doctors may also use the number staging system. This groups the TNM staging system for salivary gland cancer into 4 main stages, from 1 to 4. Stage 1 is an early cancer and stage 4 is an advanced cancer. Some doctors also use stage 0.
Stage 0 cancer or carcinoma in situ means the cancer is at a very early stage. The cancer cells are only in the lining of the salivary duct or sacs. The cancer is not in the lymph nodes and has not spread anywhere else in the body.
In the TNM staging system, stage 0 salivary gland cancer is the same as Tis, N0, M0.
Stage 1 cancer means the cancer is 2cm or smaller. It has not grown into nearby tissues. The cancer has not grown into nearby lymph nodes and has not spread to other parts of the body.
In the TNM staging system, stage 1 salivary gland cancer is the same as T1, N0, M0.
Stage 2 cancer means the cancer is larger than 2cm but no bigger than 4cm. It has not grown into the lymph nodes and has not spread to other parts of the body.
In the TNM staging system, stage 2 salivary gland cancer is the same as T2, N0, M0.
Stage 3 is divided into a and b.
Stage 3a can mean one of the following:
the cancer is no larger than 4cm and is not growing into nearby tissues. It has spread to 1 to 3 lymph nodes but not into tissues surrounding the lymph nodes. It has not spread to other parts of the body
the cancer is more than 4cm or it can be any size and has grown into nearby tissues or organs. It has not grown into the nearby lymph nodes. It has not spread to other parts of the body
In the TNM staging system, stage 3a salivary gland cancer is the same as one of the following:
T1 or T2, N1, M0
T3 or T4, N0, M0
Stage 3b can mean one of the following:
the cancer is no larger than 4cm and is not growing into nearby tissues. It has spread to more than 3 lymph nodes. Or it has spread to any number of lymph nodes and grown into the tissue around at least 1 lymph node. It has not spread to other parts of the body
the cancer is more than 4cm. Or it can be any size and has grown into nearby tissues or organs. It has grown into any number of lymph nodes and may have grown into the area around the lymph nodes. It has not spread to other parts of the body
In the TNM staging system, stage 3b salivary gland cancer is the same as one of the following:
T1 or T2, N2, M0
T3 or T4, N1 or N2, M0
Stage 4 cancer means the cancer is advanced. The cancer is any size and might have grown into nearby tissues. It may or may not have grown into nearby lymph nodes. It has spread to other parts of the body.
In the TNM staging system stage 4 salivary gland cancer is the same as any T, any N, M1.
The grade of a cancer tells you how much the cancer cells look like normal cells under the microscope. Doctors sometimes use grading as well as staging to group (categorise) salivary gland cancer. It gives your doctor an idea of how the cancer might behave and what treatment you need.
Doctors use 3 grades to describe salivary gland cancer:
grade 1 (low grade) means the cancer cells look like normal salivary gland cells. These can also be called well differentiated cells
grade 2 (intermediate grade) means the cancer cells look slightly different to normal salivary gland cells. These can also be called moderately differentiated cells
grade 3 (high grade) means the cancer cells look very abnormal and not much like normal salivary gland cells. These can also be called poorly differentiated cells
Higher grade cancers tend to be fast growing and more likely to spread.
Your biopsy, scans and tests will give some information about the stage of your cancer. But your doctor might not be able to tell you the exact stage until after you have surgery.
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)
which salivary gland the cancer started in
other health conditions that you have
Last reviewed: 29 Sept 2026
Next review due: 29 Sept 2029
The type of salivary gland cancer means the type of cell the cancer started in. Mucoepidermoid carcinomas are the most common type of salivary gland cancer.
Treatment for salivary gland cancer depends on where the cancer is, the size, whether it has spread anywhere else and your health.
Your risk of salivary gland cancer increases with age. Radiation treatment to the head and neck area can also increase your risk.
Salivary gland cancer can start in any of the glands that make spit (saliva). As well as 3 major pairs of salivary glands we have over 600 smaller, minor salivary glands throughout the lining of the mouth and throat.
