Hello. I'm trying to understand my dx. It is Stage 4a, T2 N2b M0, with the left tonsil as the primary which has been removed. I have started radiation (6 wks 5 days a week) with three 6hr chemos throughout. Also a possible rad neck dissection at the end of my radiation. I have not asked about a prognosis because there are so many variables. I guess I'm asking what these numbers and letters mean, especially the (a) after stage 4 because it is the only one I can't seem to find explained.Oh I also already had 2 nodes removed that were poorly differintiated and have atleast 2 more nodes that showed on the CT and Petscan. I'm not a negative person. I'm actually quite upbeat but the more I read it seems maybe I should be taking this a little more serious. I guess I need a little help understanding this diagnosis. Thank you.

Lee --

Welcome to OCF. You'll get a lot of support and help here.

Be sure to look through the main part of the site, which contains tons of information -- including this discussion of staging (the letters and numbers) and grading (well differentiated, moderately well differentiated, etc.).

The chart on page 6 of the .pdf file referenced on the staging/grading page goes into greater detail and will tell you what that (a) means. (In your case, it's oropharynx. The letter has to do with the extent the cancer has moved into surrounding areas.)

Keep coming back, and encourage your wife and other family members to sign on as well -- there is information here that will help them, too.

All the best,
Leslie

Thank you very much, Leslie.

Leslie got most of the important pages but the cut to the chase page is here http://www.oralcancerfoundation.org/facts/stages_cancer.htm