Staging
Staging is a process that tells a doctor if the cancer has spread and if it has, how far. Staging for salivary gland cancer depends on the location and extent of the tumor, and whether it has invaded any lymph nodes or nearby structures. Staging is an important step in evaluating prognosis and treatment options.
Stage I
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Description
- Tumor is 2 cm or less in diameter and has not spread to nearby soft tissues.
Treatment
- Surgery to remove the tumor, sometimes followed by radiation therapy.
Stage II
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Description
- Tumor is greater than 2 cm but no greater than 4 cm in diameter. Cancer has not spread to any nearby soft tissues.
Treatment
- Surgery to remove the tumor (may be more extensive than stage 1), sometimes followed by radiation therapy.
Stage III
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Description
- Tumor is greater than 4 cm in diameter and/or tumor has spread to nearby soft tissues.
- OR
- Tumor may be any size and may or may not have spread to nearby soft tissues. Cancer has spread to a single lymph node on the same side of the neck, which is 3 cm or less in diameter.
Treatment
- Surgery to remove the tumor, nearby tissues, and lymph nodes, usually followed by radiation therapy. Radiation (sometimes combined with chemotherapy) may be the alternative treatment option in cases in which surgery can not be safely performed.
Stage IVa
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Description
Moderately advanced local disease
- Tumor has spread to a critical structure outside the saliva gland such as the skin, jaw bone, ear canal, and/or facial nerve.
Treatment
- Surgery to remove the tumor, nearby tissues, and lymph nodes, usually followed by radiation therapy. Given the involvement of critical structures, surgery to remove the cancer may also require additional reconstructive procedures to repair these structures such as the jaw bone or facial nerve. Radiation (sometimes combined with chemotherapy) may be the alternative treatment option in cases in which surgery can not be safely performed. Clinical trials.
Stage IVb
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Description
Very advanced disease
- Tumor has spread to structures which cannot be safely removed surgically such as the skull or the carotid artery.
- This level of advanced disease holds very poor cure rates. Radiation, generally combined with chemotherapy, may be the primary treatment. Additionally, patients are referred to a medical oncologist familiar with clinical trilas for advanced salivary gland cancers.
Treatment
Stage IVc
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Description
- Cancer has spread to distant organs or distant parts of the body.
Treatment
- Surgery and/or radiation therapy may be an option in select case to halt or remove the growth of cancer from the head and neck, though these treatments do not offer a cure of the cancer. Both Chemotherapy and involvement in clinical trials are important tools to slow tumor growth.
