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.)

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.

Pea, peanut, walnut, and lime show tumor sizes.

Stage I

In stage I, cancer has formed and the tumor is 2 centimeters or smaller. Cancer has not spread to the lymph nodes.

Stage II

In stage II, the tumor is larger than 2 centimeters but not larger than 4 centimeters, and cancer has not spread to the lymph nodes.

Stage III

In stage III, the tumor:

• may be any size and has spread to a single lymph node that is 3 centimeters or smaller, on the same side of the neck as the cancer; or
• is larger than 4 centimeters.

Stage IV

Stage IV is divided into stages IVA, IVB, and IVC as follows:

• In stage IVA, the tumor:
  • has spread to nearby tissues in the lip and oral cavity; or
  • is any size and may have spread to nearby tissues in the lip and oral cavity. Cancer has spread to 1 or more lymph nodes on one or both sides of the neck, and the involved lymph nodes are 6 centimeters or smaller.
• In stage IVB, the tumor:
  • may be any size and has spread to one or more lymph nodes that are larger than 6 centimeters; or
  • has spread to the muscles or bones in the oral cavity, or to the base of the skull and/or the carotid artery. Cancer may have spread to one or more lymph nodes on one or both sides of the neck.
• In stage IVC, the tumor has spread beyond the lip and oral cavity to other parts of the body. The tumor may be any size and may have spread to the lymph nodes.