Lung cancer staging is an integral part in knowing what your treatment options are. Typically, cancers that are an earlier stage are easier to treat but many people are able to live a long time with advanced-stage disease.

Key Points

  • Lung cancer staging means finding out:
    • Where the lung cancer cells are located.
    • The size of the lung cancer tumor.
    • If and where the lung cancer has spread.
  • Lung cancer staging helps determine what treatment options you have.
  • Staging gives some information about lung cancer prognosis but does not predict how long you will live.

In Lung Cancer Basics, we discuss the main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

Lung cancer staging is the next step in the lung cancer diagnosis process. Your team will use results from tests and tissue samples to determine your lung cancer stage. Staging helps determine your recommended treatment plan.

Lung cancer staging also is used to discuss the general outlook for your recovery. This is sometimes called a lung cancer prognosis. Doctors can estimate prognosis based on the experiences of other people with the same type and stage of cancer. Keep in mind that no one knows for sure how your cancer will respond to treatment. Every person is different.

Three factors are used to determine lung cancer stage (sometimes referred to as the TNM classification system). The stage of your lung cancer is determined by a combination of all of these factors.

  • T – Tumor size and location
  • N – Regional lymph node involvement. Lymph nodes are small ball-shaped immune system organs distributed throughout the body. It is important to know whether the lung cancer has spread to the lymph nodes around the lung.
  • M – Metastasis status. Metastasis status refers to which organs the cancer has spread.

Non-small cell lung cancer stages range from one to four, usually expressed in Roman numerals (0 through IV). The lower the lung cancer stage, the less the cancer has spread.

Stage 0 non-small cell lung cancer is an early stage of lung cancer that is only in the top lining of the lung can has not spread outside the lungs. Stage I non-small cell lung cancer (NSCLC) is divided into two sub-stages, 1A and 1B, based on the size of the tumor and whether it has spread to the lining of the lung. In Stage 1 NSCLC, the cancer has not spread to the lymph nodes or other parts of the body.

Stage II non-small cell lung cancer is divided into stage IIA and IIB, with each stage then broken into additional sections, depending on the size of the tumor, where it is found, and whether or not the cancer has spread to the lymph nodes. These tumors may be larger than those in stage I and have begun to spread to nearby lymph nodes or other structures near the lung. The cancer has not spread to distant organs.

Stage III lung cancers are classified as stage IIIA, IIIB or IIIC, depending on the size and location of the tumor and how far it has spread. The tumor may be hard or impossible to remove through surgery depending on where it has spread.

Stage IV non-small cell lung cancer (NSCLC) is the most advanced form of lung cancer. In stage IV, the cancer has metastasized, or spread, from the lungs into other areas of the body. For most patients, there are several treatment options available for patients with advanced-stage disease.

Small cell lung cancer is described using two stages: limited and extensive. Limited stage lung cancer is only in one lung or in the nearby tissue. Extensive stage lung cancer has spread to tissue outside of the originally affected lung like the opposite lung or distant organs.

Watch Dr. Tracey Evans talk about how lung cancer is staged and what the different stages mean.

Page last updated: April 23, 2020

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