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Stages of head and neck cancer

Radioactive iridium wire implant of the tounge
Radioactive iridium wire implant of the tounge

The 'stage' of the cancer defines whether the tumour is localised to the organ, whether it has invaded nearby structures, whether it has spread to the local lymph nodes or whether it has spread to other parts of the body. The treating oncologist needs to know the stage to decide the most suitable treatment.


The information needed to decide the stage is gathered from both clinical examination and scanning. An examination under anaesthetic is often done to obtain the most accurate stage, and to get a biopsy.


The stage is usually classified using a system called the 'TNM Staging System', where T stands for tumour, N for 'nodes' (ie lymph nodes), and M for 'metastases' (ie whether other organs are involved). Each letter is followed by a number that defines the extent of the cancer eg T2N1M0. 


The diagnosis is confirmed by taking a sample of the lump or suspicious region, and having this examined under a microscope by a specialist. The biopsy may be taken in the out patient clinic, but usually a full examination of the area is undertaken whilst the patient is under anaesthetic. This allows a much more thorough examination to be done. The biopsy can be taken during this procedure. Other tests that are done include a CT scan and an MRI scan.

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