Staging and grading of nasal and sinus cancer
The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage helps doctors decide on the best treatment for you.
The most commonly used staging systems for nasal and sinus cancer are the TNM and number staging systems.
TNM staging system
TNM stands for tumour, node and metastases.
- T describes the size of the tumour and whether it has grown into nearby tissues such as, bones, muscles or nerves. It is numbered between 0 and 4 depending on the size and extent of the tumour.
- T0 means that there are no signs of a tumour, but there may be abnormal cells that are pre-cancerous.
- A T1 nasal tumour is small and has not spread from the nasal cavity.
- A T4 nasal tumour has spread into nearby bones, nerves, tissue or areas of the skull.
- N describes whether the cancer has spread to the lymph nodes.
- N0 means that no lymph nodes are affected.
- N1, N2 or N3 means that there are cancer cells in the lymph nodes. The number depends on how many lymph nodes contain cancer cells, the size and where they are.
- M describes whether the cancer has spread to another part of the body. This is called metastatic cancer.
- M0 means the cancer has not spread.
- M1 means the cancer has spread to distant organs, such as the lungs or liver.
Number staging system
There are usually 3 or 4 number stages for each cancer type. Stage 1 describes a cancer at an early stage when it is usually small in size and has not spread. Stage 4 describes a cancer at a more advanced stage when it has usually spread to other parts of the body.
Your doctor can tell you more about the stage of your cancer.
Other terms used
Your doctor may use other terms to describe the stage of the cancer:
- Early or local – a small cancer that has not spread.
- Locally advanced – cancer that has started to spread into surrounding tissues or nearby lymph nodes, or both.
- Local recurrence – cancer that has come back in the same area after treatment.
- Secondary, advanced, widespread or metastatic – cancer that has spread to other parts of the body.
The grade of a cancer gives the doctors an idea of how quickly it may develop. Doctors will look at a sample of the cancer cells under a microscope to find the grade of the cancer.
- Grade 1 or low grade – the cancer cells look like normal cells and usually grow slowly.
- Grade 2 and 3 – the cancer cells look different to normal cells and are slightly faster growing.
- Grade 4 or high grade – the cancer cells look very different to normal cells and may grow more quickly.
Below is a sample of the sources used in our nasal and sinus cancer information. If you would like more information about the sources we use, please contact us at firstname.lastname@example.org
British Association of Head and Neck Oncologists. Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines. 2016. Available from: https://www.bahno.org.uk/_userfiles/pages/files/ukheadandcancerguidelines2016.pdf (accessed September 2018).
Lund VJ, Clarke PM, Swift AC et al. Nose and paranasal sinus tumours: United Kingdom National Multidisciplinary Guidelines. The Journal of Laryngology and Otology, 2016: 130 (Suppl 2): S111-S118, Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873911/ (accessed September 2018)
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.
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