Staging lung cancer looks at where the cancer is located and whether it has spread to other parts of the body.
The stage of cancer is the major focus in determining a treatment plan. It is important to understand the concept of “stage” for lung cancer, as it classifies you into a group of patients with comparable outcomes who are eligible for similar treatment. The following review of treatments by stage of non small cell lung cancer and small cell lung cancer provides only general descriptions of the usual approaches. There are many variations of existing options, and many new treatments are emerging that provide additional treatment options. Please note that non-small and small cell lung cancer are treated differently.
Non Small Cell Lung Cancer (NSCLC) Staging
Stage IA, the cancer is smaller than three centimeters (slightly less than 1 1/4 inches), has not spread to the membranes that surround the lungs, lymph nodes or other distant organs, and does not affect the main branches of the bronchi.
Stage IB means the tumor is either larger than three centimeters or may involve a portion of the main bronchus or the visceral pleura (sac surrounding the lung). However, stage IB tumors do not involve lymph nodes or extend to the center of the chest outside of the lung and do not involve more than one area in the lung.
Stage IIA, the tumor is no larger than three centimeters, has not spread to the membranes that surround the lungs, and does not affect the main branches of the bronchi. However, it has spread to the lymph nodes within the cancerous lung but not to distant sites.
Stage IIB means the cancer is either larger than three centimeters and has spread to the membranes that surround the lung and/or the lymph nodes within the same cancerous lung, or has spread to the chest wall, the diaphragm, the membranes that surround the space between the lungs, or the membranes that surround the sac of the heart without involving lymph nodes around the heart and trachea (mediastinal lymph nodes) or distant organs.
Stage IIIA is confined to the lung and the lymph nodes around the windpipe or in the mediastinum (the place behind the chest bone and in front of the heart) on the same side as the cancerous lung.
Stage IIIB can be a tumor of any size that may involve the bronchus, trachea (main airway), esophagus, backbone, or the fluid in the space surrounding the lung and, most importantly, has spread to the lymph nodes near the collarbone on either side and/or the lymph nodes within the lung or mediastinal lymph nodes on the side that is opposite the cancerous lung. Sometimes Stage IIIB tumors are referred to as wet or dry. Wet means the cancer has spread into the fluid that fills the space surrounding each lung (pleural fluid) or around the heart (pericardial fluid).
Stage IV is the most advanced form because the cancer has spread from the lungs to distant parts of the body such as the liver, adrenal glands, brain or bone.
Small Cell Lung Cancer Staging
Small cell lung cancer is generally categorized as either limited-stage or extensive-stage disease:
- Limited stage—tumors typically are on one side of the chest in one lung and within the surrounding area that can be treated by radiation.
- Extensive stage—tumors have spread outside one lung to the other lung or to other areas of the body.