At some point, your doctor will tell you what stage your cancer is. Put simply, the stage describes how widespread or advanced the cancer is. Determining the stage helps doctors explain the extent of the cancer to you. It also helps them determine how to move forward with treatment, including surgery, radiation therapy, or chemotherapy. You will also find out the grade of your cancer, which tells you how fast or slow the tumor is growing.
Your doctor will assign a stage to your cancer after your physical exam and the initial results from your biopsy or imaging tests. The stage may be adjusted if you have additional tests or after surgery.
There are four stages of salivary gland cancer, starting at one and going up to four. (They are represented by the Roman numerals I, II, III, and IV.)
The following staging system applies only to the major salivary glands, which include the parotid, submandibular, and sublingual glands.
Tumors in the minor salivary glands (mucus-secreting glands in the lining membrane of the upper aerodigestive tract) are staged according to where the cancer started (e.g., oral cavity, sinuses, etc.).
Stage I describes a very early stage of cancer. The tumor is not more than 2 centimeters, and the cancer has not reached the lymph nodes.
Stage II describes a tumor that is larger than 2 centimeters but not more than 4 centimeters. Stage II cancer has not reached the lymph nodes.
Stage III salivary gland cancer describes cancer that either is larger than 4 centimeters or has spread to a lymph node in the neck.
Stage IV is the most advanced stage of salivary gland cancer. It may be any size, but it has spread to:
- nearby soft tissue
- one large lymph node (more than 3 centimeters in size) and on the same side of the neck as the tumor; multiple lymph nodes of any size on the same side of the neck as the tumor; or one lymph node of any size on the opposite side of the neck as the tumor
- the skin, jawbone, ear canal, facial nerve, base of the skull, or carotid artery
- distant parts of the body beyond the head and neck
Salivary gland cancer may be stage IV when it is first diagnosed, or it can be recurrent salivary gland cancer (cancer that has come back after treatment). The cancer may come back in the part of the body where it originally developed (regional recurrence), in the lymph nodes (regional relapse), or in another part of the body (called distant recurrence).
Stage III and stage IV cancers are more likely to come back than earlier-stage ones.
Salivary Gland Tumor Grade
Most salivary gland cancers are also characterized according to their grade. The grade of a tumor tells how fast the cancer cells are growing, based on how the cells look under a microscope. This information helps your doctor make decisions about how best to care for you.
Salivary gland cancers are either low grade or high grade. Low-grade cancers grow more slowly than high-grade cancers. A higher-grade cancer may require immediate or more-aggressive treatment.