Skip Navigation

Stages of Lip and Oral Cavity Cancer

After lip and oral cavity cancer has been diagnosed, tests are done to find out if cancer cells have spread within the lip and oral cavity or to other parts of the body.

The process used to find out if cancer has spread within the lip and oral cavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of the tests used to diagnose lip and oral cavity cancer are also used to stage the disease. (See the General Information section.)

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if lip cancer spreads to the lung, the cancer cells in the lung are actually lip cancer cells. The disease is metastatic lip cancer, not lung cancer.

The following stages are used for lip and oral cavity cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the lining of the lips and oral cavity. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed. The tumor is 2 centimeters or smaller and the deepest point of tumor invasion is 5 millimeters or less.

Stage II

In stage II, the tumor:

  • is 2 centimeters or smaller and the deepest point of tumor invasion is greater than 5 millimeters; or
  • is larger than 2 centimeters but not larger than 4 centimeters and the deepest point of tumor invasion is 10 millimeters or less.

Stage III

In stage III, the tumor:

  • is larger than 2 centimeters but not larger than 4 centimeters and the deepest point of tumor invasion is greater than 10 millimeters; or
  • is larger than 4 centimeters and the deepest point of tumor invasion is 10 millimeters or less; or
  • has spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the primary tumor.

Stage IV

Stage IV is divided into stages IVA, IVB, and IVC.

  • In stage IVA, the tumor:
    • is larger than 4 centimeters and the deepest point of tumor invasion is greater than 10 millimeters; or cancer has spread to the outer surface of the upper or lower jawbone, into the maxillary sinus, or to the skin of the face. The cancer may have spread to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the primary tumor; or
    • is any size or cancer has spread to the outer surface of the upper or lower jawbone, into the maxillary sinus, or to the skin of the face. Cancer has spread:
      • to one lymph node that is 3 centimeters or smaller, on the same side of the neck as the primary tumor, and cancer has spread through the outside covering of the lymph node into nearby connective tissue; or
      • to one lymph node that is larger than 3 centimeters but not larger than 6 centimeters, on the same side of the neck as the primary tumor; or
      • to multiple lymph nodes that are not larger than 6 centimeters, on the same side of the neck as the primary tumor; or
      • to multiple lymph nodes that are not larger than 6 centimeters, on the opposite side of the neck as the primary tumor or on both sides of the neck.
  • In stage IVB, the tumor:
    • has spread to one lymph node that is larger than 6 centimeters; or
    • has spread to one lymph node that is larger than 3 centimeters, on the same side of the neck as the primary tumor, and cancer has spread through the outside covering of the lymph node into nearby connective tissue; or
    • has spread to one lymph node of any size on the opposite side of the neck as the primary tumor, and cancer has spread through the outside covering of the lymph node into nearby connective tissue; or
    • has spread to multiple lymph nodes anywhere in the neck, and cancer has spread through the outside covering of any lymph node into nearby connective tissue; or
    • has spread further into the muscles or bones needed for chewing, or to the part of the sphenoid bone behind the upper jaw, and/or to the carotid artery near the base of the skull. Cancer may have also spread to one or more lymph nodes of any size, anywhere in the neck.
  • In stage IVC, the tumor:
    • has spread beyond the lip or oral cavity to other parts of the body, such as the lung, liver, or bone.

Lip and oral cavity cancer can recur (come back) after it has been treated.

The cancer may come back in the lip or mouth or in other parts of the body.

This information is not intended to replace the advice of a doctor. Navigating Care disclaims any liability for the decisions you make based on this information. This information was sourced and adapted from Adapted from the National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries on www.cancer.gov.