Your Profile, Your Goals - Staging Lung Cancer
Learn about how lung cancer is staged and what the different stages mean.
Tracey Evans: Staging your cancer tells us whether your cancer has spread beyond the lungs, and if so, how much and to where. When we talk about cancer spreading, we refer to it as metastasis or metastasizing. Tumor staging information helps us to determine an appropriate treatment. When I relay the staging information to my patient, I emphasize that the real importance of staging is to provide information about our best treatment approach. The tests for staging are generally done at the same time as the test for type and subtype of cancer, but sometimes the staging occurs at some point following diagnosis.
Imaging tests such as x-rays, bone scans, PET and CAT scans also give information about whether a tumor has spread to other organs and which ones. It is important to note that not all patients need all of these tests. The results of one test, for example, can help the doctor decide if another test would tell us something else we need to help treat the disease. If the answer is no, there may not be any reason for further testing. I also typically recommend that patients receive a brain scan as part of their staging process to determine whether the disease has affected the brain. A brain scan is, of course, a frightening prospect, but I want to emphasize that the reason to do a brain scan as with other staging tests, is simply to get a full picture of the disease and where it is located. The more accurate we are at staging your cancer, the better we will be at selecting the best treatment options, giving you the best possible odds.
While staging can't predict how long a person will live, staging does provide some general information about prognosis and how likely we are to cure the disease. The treatments most likely to result in a cure vary for the different stages. Stage four disease usually means, with some exceptions, that the goal of treatment is no longer to cure it but to instead control the disease and to provide a good quality of life for as long as possible. We can often accomplish this for a decent period of time with some good options for treatment. Small cell lung cancer is described as limited stage when it has the following characteristics. It is only in one lung, it has not spread to distant sites outside of the lung, although it may have possibly spread to nearby lymph nodes or to the tissue between the lungs. Small cell lung cancer is classified as extensive stage when the tumor has spread into both lungs or from one lung to other regions of the body.
The most important goal of staging is to know where the cancer is so we can use the right treatments in order to actually get to it and treat it. Staging also helps to set our goals for treatment. If our goal is to completely get rid of the cancer and make sure it never comes back, for example, then you might receive powerful treatments that might make you feel quite sick but that offer the best chance of cure. If we know that we are not able to cure the cancer and our goal is for you to get as much quality time as possible, then we might recommend treatments with less severe side-effects. In this case, first and foremost, we want to make sure that the treatments you receive are not making you miserable.
Sometimes people wonder, "How can I have late-stage lung cancer, but I feel fine?" Lung cancer can spread without causing symptoms. That's why we have to make sure that we know everything we can about it and where it is. We can't just rely on symptoms in order to decide on the best treatment approach.
Approved by Scientific and Medical Editorial Review Panel. Last reviewed November 24, 2017.