About stages and grades for laryngeal cancer

Laryngeal cancer is also called cancer of the voice box (larynx). The staging of a cancer helps your doctor to decide on what treatment you should have. Grading tells them how the cancer is likely to behave.

What is staging?

The stage of a cancer means how big it is and whether it has spread. It is important because the stage often decides the treatment. The tests and scans you have to diagnose cancer give some information about the stage, but your doctor may not be able to tell you the exact stage until you have surgery.

The staging systems doctors use for cancer of the voice box (larynx)

There are different ways of staging cancers. The 2 main ways are the TNM system and the number staging system.

You may not be familiar with these terms but you can ask your doctor if you would like to know more.

Your doctor might also refer to the stage of your cancer as:

• early
• locally advanced
• advanced

Understanding your stage of cancer may show why your doctors have chosen a particular treatment.

Staging of cancer of the larynx is complex. There are 3 parts of the larynx and doctors stage each part separately. Each part is surrounded by slightly different structures and tissues in the voice box.

The 3 parts of the voice box are the:

• area above the vocal cords (supraglottis)
• vocal cords (glottis)
• the area below the vocal cords (subglottis)

Ask your doctor or specialist nurse about your staging if you are not sure about what it means.

TNM stages for cancer of the voice box (larynx)

TNM stands for tumour, node and metastasis. The system describes:

• the size of a primary tumour (T) and how far it’s grown
• whether the cancer has spread to the lymph nodes (N)
• whether the cancer has spread to a different part of the body such as the lungs (M)

Number stages for cancer of the voice box (larynx)

Number staging systems use the TNM system to divide cancers into stages. Most types of cancer have 4 stages, numbered from 1 to 4. Stage 1 is the earliest stage and stage 4 is advanced cancer.

The grade of your cancer

The grade of a cancer tells you how much the cancer cells look like normal cells under a microscope. Doctors also use the term differentiation to describe how developed or mature a cell is.

There are 3 grades of laryngeal cancer:

• Grade 1 (low grade) - the cancer cells look very much like normal larynx cells (they are well differentiated)
• Grade 2 (intermediate grade) - the cancer cells look slightly like normal larynx cells (they are moderately differentiated)
• Grade 3 (high grade) - the cancer cells look very abnormal and don't look like normal larynx cells (they are poorly differentiated)

The grade of a cancer gives your doctor an idea about how the cancer is likely to behave. 

Low grade cancers are usually slower to grow and less likely to spread. This is only a guide. Your doctor will consider this, along with all your test results when deciding which treatment is best for you.