The stage of a cancer tells you how big it is and whether it has spread. This is important, as the stage helps your doctor decide which treatment you need.
Your 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 staging systems described here are for cancers of the major salivary glands.
We have 3 main pairs of major salivary glands, the:
- parotid glands – just under the lobes of your ears
- sublingual glands – under your tongue
- submandibular glands – under each side of your jawbone
As well as the 3 major pairs of salivary glands we have over 600 smaller, minor salivary glands throughout the lining of the mouth and throat. Minor salivary gland cancers are staged differently, depending on where they start.
Your team might also use the TNM staging system to stage your cancer.
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
The number staging system
There are 4 main number stages of salivary gland cancer:
This means the tumour is only in the salivary gland and is smaller than 2cm. In the TNM staging system stage 1 is T1, N0, M0.
The main treatment for stage 1 salivary gland cancer is surgery.
This means that the tumour is only in the salivary gland and is between 2 and 4 cm. In the TNM staging system stage 2 is T2, N0, M0.
The main treatment for stage 2 salivary gland cancer is surgery.
This means 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
In the TNM staging system stage 3 is T3, N0, M0 or T0-3, N1, M0.
You might have surgery to remove the tumour and surgery to remove the lymph nodes in your neck. You might also have radiotherapy after surgery.
There are 3 groups within stage 4 salivary gland cancer. Stage 4 cancer is also called advanced cancer.
Stage 4a means either:
- the tumour has grown into the tissues around the salivary gland, the skin, the jawbone, ear canal or facial nerve. There might be cancer cells in one lymph node on the same side of the neck. The lymph node is 3cm or smaller.
- there are cancer cells in one or more lymph nodes on one or both sides of the neck. If there is spread to one lymph node, it is larger than 3cm but smaller than 6cm. If there are cancer cells in more than one lymph node, these are smaller than 6cm.
In the TNM staging system stage 4a is T4a, N0-1, M0. Or T0-T4a, N2, M0.
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). Or 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.
In the TNM staging system stage 4b is any T, N3, MO. Or T4b, any N, M0.
Stage 4c means that the cancer has spread to another part of the body, such as the lungs.
Your doctor might recommend surgery to remove all or part of the cancer and help relieve symptoms if your tumour is large. They may also suggest radiotherapy and chemotherapy.
In the TNM staging system stage 4c is the same as any T, any N, M1.
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)
- where the cancer is
- other health conditions that you have