Staging

Doctor looking at chest x-rayIn the Knowing the Basics section we discussed the different types of lung cancer small cell lung cancer (SCLC)About 10% to 15% of all lung cancers are small cell lung cancer (SCLC), named for the small cells that make up these cancers. SCLC often starts in the bronchi near the center of the chest, and it tends to spread widely through the body early in the course of the disease. and non-small cell lung cancer (NSCLC)About 85% to 90% of lung cancers are non-small cell lung cancer (NSCLC). There are three main subtypes of NSCLC, which look different under a microscope but are treated similarly.. Non-small cell lung cancer is more common. It makes up about 80 percent of lung cancer cases. This type of cancer usually grows and spreads to other parts of the body more slowly than small cell lung cancer does. There are three different types of non-small cell lung cancer: adenocarcinomaA form of non-small cell lung cancer often found in an outer area of the lung. It develops in the cells of epithelial tissues, which line the cavities and surfaces of the body and form glands., squamous cell carcinomaA form of non-small cell lung cancer usually found in the center of the lung next to an air tube (bronchus). and large cell carcinomaA form of non-small cell lung cancer that can occur in any part of the lung and tends to grow and spread faster than adenocarcinoma or squamous cell carcinoma.. Each type is different, but they are grouped together because they are treated similarly. There are two different types of small cell lung cancer: small cell carcinoma (oat cell cancer) and combined small cell carcinoma. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope.

Staging is the next step in the diagnosis process. Your team will use results from tests and tissue samples to determine the stage of your cancer. Staging helps to decide what your recommended treatment plan may be.
Staging means finding out:

  • where the tumor is located
  • its size
  • if and how much the lung cancer has spread

Staging is also used to discuss the general outlook for your recovery and chance of cure. This is sometimes called prognosisA prediction of the probable course and outcome of a disease.. Keep in mind that no one knows for sure how your cancer will respond to treatment. Every person is different. It is possible for doctors to estimate based on the experiences of other people with the same type and stage of cancer.

Non-small cell lung cancer stages range from one to four. The stages are usually expressed in roman numerals (I through IV). The lower the stage, the less the cancer has spread. Small cell lung cancer is described using two stages: limited and extensive. Three factors are used to determine lung cancer stage (sometimes referred to as the TNM classification system). The stage of your cancer is determined by a combination of all of these factors.

T: tumor size and location

N: regional lymph node involvement. Lymph nodesSmall ball shaped organs of the immune system distributed all over the body. are small ball shaped organs of the immune system distributed all over the body. It is important to know if the cancer has spread to the lymph nodes around the lung when staging the cancer.

M: metastasis status. MetastasisThe spread of cancer from its primary site to other places in the body. status refers to which organs the cancer has spread. Need a reminder on how lung cancer works? Check out Knowing the Basics.

Stages of Non-Small Cell Lung Cancer

Occult Stage Lung cancer cells are found in certain body fluids, but a tumor cannot be seen in the lung through imaging.
Stage 0
(carcinoma in situ)
Cancer cells are found only in the innermost lining of the lung. The tumor has not grown through the lining.
Stage I

IA: The tumor is no more than 3 centimeters across (about the size of a cranberry).

No surrounding tissue or lymph node involvment.

IB: No lymph node inolvement and one of the following:
  • Tumor no more than 3 cm across
  • Tumor has grown into the main bronchus
  • Tumor has grown into the pleura
Stage II

IIA: No more than 3 cm across

Cancer cells in lymph nodes

IIB: One of the following:
  • Not in lymph nodes but in the chest wall, diaphragm, pleura, main bronchus or tissue that surrounds the heart
  • In lymph nodes and is 3 cm, has grown into the main bronchus or has grown into the pleura
Stage III

IIIA: Any size

  • In the lymph nodes near the lungs and between the lungs on the same side of the chest as the lung tumor

IIIB: Any size

  • In lymph nodes on the opposite side of the chest as the tumor and may be in other near by organs
Stage IV

- In more than one lobe of the same lung,
- In the other lung or
- In other parts of the body like the brain, liver or bone.

Stages of Small Cell Lung Cancer

Doctors describe small cell lung cancer using two stages:

  • Limited stage: Cancer is found only in one lung and sometimes the lymph nodes on the same side of the chest.
  • Extensive stage: Cancer has spread to the other lung, to lymph nodes on the other side of the chest or to distant organs.

Early detection of lung cancer can increase survival rates. Call the Lung Helpline at 1-800-LUNGUSA or talk to your doctor about lung cancer screening.