What are the Different Stages of Oral Cancer?

Understanding the Different Stages of Oral Cancer & Treatment Options

Understanding the different stages of oral cancer is crucial for catching it early, getting effective treatment, and achieving better outcomes. In this guide, we will dive into each stage in detail, along with the treatment options available. This information will not only clarify how advanced the cancer is but also assist your doctor in deciding the best treatment plan for you.

Stage 0 Oral Cancer

• Stage 0 oral cancer, also known as carcinoma in situ, is a preliminary stage of oral cancer. At this stage, the cancer is confined to the epithelium(the outermost layer of cells) and has not attacked deeper tissue layers, spread to lymph nodes or other parts of the body, or become severe.
• Patients with stage 0 oral cancer may not develop any symptoms. However, a seasoned professional can identify them during a routine oral examination.

Treatment:

Treatment for stage 0 oral cancer comprises:

• Surgical stripping or Mohs surgery.
• Radiation therapy(If carcinoma in situ comes back after surgery)

Stage 1 Oral Cancer

• Stage 1 oral cancer denotes an early stage of mouth cancer. This is because the tumour that has developed is not more than 2 centimetres in size at this point. In addition, the cancer has not spread to the lymph nodes.

Treatment:

• Stage 1 oral cancer treatment options depend on the location of the tumour in the body. However, doctors opt for surgery to remove the abnormal growth of body tissue.
• Another treatment option is radiation(as effective as surgery). After that, doctors suggest radiation or chemoradiation to prevent the mouth cancer from coming back.

Stage 2 Oral Cancer

• At this stage, the tumour grows and reaches a size of 2–4 centimetres. Similar to stage 1, stage 2 oral cancer does not spread to the lymph nodes or nearby areas.

Treatment:

• It is almost similar to stage 1. Your doctor may start with surgery or suggest radiation therapy if surgery is not possible.

Stage 3 Oral Cancer

• When the tumour grows bigger and reaches a size that is larger than 4 centimetres, medical professionals consider this stage 3 oral cancer. However, the positive fact is that it does not spread to lymph nodes. A tumour can be of any size and might spread to a lymph node close by, located on the same side of the neck as the tumour.
• However, you can rest assured that cancer has not spread to other parts of the body at this stage.

Treatment:

• As this is quite a severe stage, a doctor usually recommends surgery and radiation. They may also recommend hypofractionated radiation therapy to ensure more effective treatment.

Stage 4 Oral Cancer

• This is known as late-stage mouth cancer. Experts further divide this stage into sub-categories like stages 4A, 4B, and 4C.

Stage 4A

• When the tumour is any size and spreads to nearby body parts such as the jaw bone, facial skin, or maxillary sinus, then it is called Stage 4A oral cancer by medical professionals. At this stage, the cancer may not have spread to distant sites yet but has spread to the lymph nodes. You may notice it on the same side as the tumour on a usual basis.

Stage 4B

• Stage 4B oral cancer refers to a stage when a tumour  (that can be of any size) may have extended into adjacent tissues or body parts. While it typically affects one or more lymph nodes on both sides of the neck, it has not yet reached distant body parts, such as your lungs.
• In rare cases, the tumour may not affect lymph nodes but has grown and reached the adjacent structures. It can be the base of the skull or nearby areas of the carotid artery. Healthcare professionals consider this a very advanced stage of mouth cancer.

Stage 4C

• Stage 4C oral cancer refers to the stage when the tumour, no matter how big, has spread to distant body parts, such as the lungs. Even if the tumour has not reached the lymph nodes, doctors still consider it stage 4C as it has spread to distant parts of the human body.

Treatment

Doctors may suggest surgery followed by chemoradiation at this stage. Other treatment options are:

• Immunotherapy
• Chemotherapy
• Targeted therapy

Note that oral cancers in stages III and IV have a higher chance of returning compared to earlier-stage cancers. It may recur in the body part where it initially developed, in the lymph nodes, or in any other part of the body.