If oral cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. Many of the tests listed in the diagnosis section are performed to determine if the cancer has spread and to where.

Doctors describe the stage of the cancer based on the size of the tumor, whether it has invaded nearby tissues, and whether it has spread to the lymph nodes or other tissues.

For oral cancers, stages 1 and 2 are combined and classified as “early cancer.” Stages 3 and 4 are classified as “advanced cancer.” Below are the details of each class.

  • Early Cancer Lip or Oral Cancers - Stage 1 or 2 oral cancer is usually a small tumor (smaller than a walnut), and no cancer cells are found in the lymph nodes.
  • Advanced Cancer Lip or Oral Cancers - Stage 3 or 4 oral cancer is usually a large tumor (as big as a lime). The cancer may have invaded nearby tissues or spread to lymph nodes or other parts of the body.

When oral cancer spreads, cancer cells may be found in the lymph nodes in the neck or in other tissues of the neck. Cancer cells can also spread to the lungs, liver, bones, and other parts of the body. When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells as the primary (original) tumor. For example, if oral cancer spreads to the lungs, the cancer cells in the lungs are actually oral cancer cells. The disease is called metastatic oral cancer, not lung cancer. It’s treated as oral cancer, not lung cancer. Doctors sometimes call the new tumor “distant” or metastatic disease.