Understanding your diagnosis

If your medical team discovers that it is cancer that is causing your symptoms, you will begin treatment straight away. Several factors will determine the course of treatment recommended to you, and your doctors will be testing and observing your cancer in order to treat you the best way possible.

Factors affecting how your cancer is treated include: 

  • The location of the primary (original) tumour
  • The size of the tumour
  • The aggressiveness of your cancer: how quickly the cells are dividing and increasing
  • Whether the cancer has spread to your lymph nodes in your immune system
  • Whether the cancer has spread to any other part of your body (known as ‘metastasised’)


Your doctors will use a system called TNM to describe your cancer. This involves grading several of the aspects above: 

T stands for ‘tumour’, and is graded on tumour size from 0 to 4 (with 0 the smallest and 4 the largest)

N stands for ‘lymph nodes’, and is graded on how much the cancer has spread to your lymph nodes from 0 to 3 (with 0 being the least and 3 being the most)

M stands for ‘metastasised’, and is graded on whether the cancer has spread from the original location to other parts of the body. This is graded with either a 0 (hasn’t spread) or a 1 (has spread).

For example, a patient may have a diagnosis of T1 N1 M0. There are other letters used to further describe factors in the state of your cancer while setting your treatment, but it is unlikely your doctor will go into that much depth with you. 

Your medical team will also look at the cancer cells to see how quickly they are dividing and growing – this tells them how aggressive the tumour is. There are three stages generally used to describe this:

Low Grade or Grade 1. Least aggressive: the cells look similar to normal cells in the head and neck.

Moderate Grade or Grade 2. Moderately aggressive: the cells are more abnormal than in Grade 1, and there is more oncern that the cancer may spread.

High Grade or Grade 3. Most aggressive: the cells look very abnormal and are more likely to spread.

Once your medical team understands what they are dealing with, they should help you in understanding it too. If there is any part of your diagnosis that you don’t understand, be sure to ask your doctors and nurses for more information. Knowing what to expect and what your options are is important as you head into the next stage: treatment.

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