Staging of nasopharyngeal 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 nasopharyngeal 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 where the tumour is in the nasopharynx, nose and throat. It also describes whether it has grown into nearby tissues, such as bones, nerves or muscles. 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 tumour is only in the nasopharynx and the nose, or back of the throat (oropharynx).
    • A T4 tumour has grown further into nearby nerves, bones or other 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 neck 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.

The 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.

Grading of nasopharyngeal cancer

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.

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