Pharyngeal cancer

Stage 4 hypopharyngeal cancer can be divided into stages 4A, 4B or 4C.

Stage 4A means one of the following:

Cancer has spread to the thyroid gland and the tissues around it, the area around the trachea (windpipe), the esophagus, or the muscles and tissues of the neck. The cancer may also have spread to 1 lymph node on the same side of the neck as the tumour, and the lymph node is no larger than 3 cm.

OR

Cancer has spread to the thyroid gland and the tissues around it, the area around the trachea, the esophagus, or the muscles and tissues of the neck. The cancer has spread to 1 lymph node on the same side of the neck as the tumour, and the lymph node is between 3 and 6 cm, or cancer has spread to more than 1 lymph node anywhere in the neck and the nodes are 6 cm or larger.

Stage 4B means one of the following:

The tumour is any size and has spread to the thyroid gland and the tissues around it, the tissues around the trachea, the esophagus or the muscles and tissues of the neck. The cancer has spread to 1 lymph node that is larger than 6 cm, or it has spread into the tissues surrounding the lymph node.

OR

The cancer has spread to the tissue covering the muscles of the spine, the area around the major artery in the neck (carotid artery) or in the area between the lungs. The cancer has also spread to lymph nodes in the neck.

Stage 4C means the following:

Cancer has spread to distant parts of the body (called distant metastasis), such as to the liver, lungs or bones.

Recurrent hypopharyngeal cancer means that the cancer has come back after it has been treated.

Local recurrence means that the cancer has come back in the same place or close to where it first started.

Regional recurrence means that the cancer has come back in tissues or lymph nodes close to where it first started.

Distant recurrence or distant metastasis means that the cancer has come back in a different part of the body from where it started.

The following are the stages of oropharyngeal cancer. The oropharynx is the middle part of the pharynx.

The tumour is only in the lining of the oropharynx. This is also called carcinoma in situ.

The tumour is 2 cm or smaller.

The tumour is larger than 2 cm but not larger than 4 cm.

The tumour is larger than 4 cm or it has grown into the epiglottis (a flap of movable cartilage in the throat that closes the larynx when you swallow).

OR

The cancer has spread to 1 lymph node in the neck on the same side as the tumour. The lymph node is no larger than 3 cm.

Stage 4 oropharyngeal cancer can be divided into stages 4A, 4B or 4C.

Stage 4A means one of the following:

The tumour has spread to the larynx, lower jaw, the roof of the mouth or the muscles that move the tongue. It may have spread to 1 lymph node, which is 3 cm or smaller, on the same side of the neck as the tumour.

OR

The tumour is of any size but has spread to the epiglottis, the larynx, roof of the mouth, lower jaw or the muscles that move the tongue.

OR

The tumour has spread to 1 lymph node that is larger than 3 cm but not larger than 6 cm on the same side of the neck as the tumour, or the tumour has spread to more than 1 lymph node in any part of the neck and each lymph node is 6 cm or smaller.

Stage 4B means one of the following:

Cancer has spread to the muscles of the lower jaw, the bone near the muscles of the lower jaw, the base of the skull or the area behind the nose, around the main artery in the neck (carotid artery), and to the lymph nodes in the neck.

OR

The tumour is any size and has spread to other parts of the head or the neck. Cancer has spread to a lymph node that is larger than 6 cm or has spread into the tissues surrounding the lymph node.

Stage 4C means the following:

Cancer has spread to distant parts of the body (called distant metastasis), such as to the lungs, liver or bones.

Recurrent oropharyngeal cancer means that the cancer has come back after it was treated.

Local recurrence means that the cancer has come back in the same place or close to where it first started.

Regional recurrence means that the cancer has come back in tissues or lymph nodes close to where it first started.

Distant recurrence or distant metastasis means that the cancer has come back in a different part of the body from where it started.

Many cases of oropharyngeal cancer are linked to an infection with the human papillomavirus (HPV). HPV-related oropharyngeal cancer is often more advanced by the time it’s diagnosed, but people who have HPV-related oropharyngeal cancer have better rates of survival than people with oropharyngeal cancer who don’t test positive for HPV. For this reason, doctors have developed a new staging system for HPV-related oropharyngeal cancer.

The tumour is only in the tissue lining the oropharynx. This is also called carcinoma in situ.

The tumour is not larger than 4 cm. The cancer may have spread to one lymph node in the neck on the same side as the tumour. The lymph node is not larger than 6 cm.

The tumour is not larger than 4 cm and the cancer has spread to one or more lymph nodes on the opposite side of the neck as the tumour or to lymph nodes on both sides of the neck. The lymph nodes are not larger than 6 cm.

OR

The tumour is larger than 4 cm or has grown to the epiglottis (a flap of movable cartilage in the throat that closes the larynx when you swallow). The cancer may have spread to lymph nodes in the neck, which are not larger than 6 cm.

The cancer has spread to 1 or more lymph nodes in the neck, which are larger than 6 cm.

OR

The tumour has grown around the main artery in the neck (carotid artery) or has grown into any of the following:

• the voice box (larynx)
• the muscles of the tongue
• nearby bones of the skull
• the bony part of the roof of the mouth (hard palate)
• the lower jawbone (mandible)
• the upper part of the throat (nasopharynx)

Cancer has spread to distant parts of the body (called distant metastasis), such as to the lungs, the liver or bones.

Recurrent HPV-related oropharyngeal cancer means that the cancer has come back after treatment.

Local recurrence means that the cancer has come back in the same place or close to where it first started.

Regional recurrence means that the cancer has come back in tissues or lymph nodes close to where it first started.

Distant recurrence or distant metastasis means that the cancer has come back in a different part of the body from where it started.

The following are the stages of hypopharyngeal cancer. The hypopharynx is the lower part of the pharynx.

The tumour is only in the tissue lining the hypopharynx. This is also called carcinoma in situ.

The tumour is 2 cm or smaller.

The tumour is in more than 1 area of the hypopharynx or in an area next to the hypopharynx, or it is larger than 2 cm but not larger than 4 cm. The larynx (voice box) can move normally.

The tumour is larger than 4 cm or it doesn’t allow the larynx to move normally or it has reached the esophagus.

OR

The cancer has spread to 1 lymph node in the neck on the same side of the neck as the tumour and the lymph node is no larger than 3 cm.