Lung Cancer Staging

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.

The Role of Staging

After determining your type of 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. No doctor can accurately predict the life expectancy of an individual with lung cancer.

TNM Classification

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

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 and the better the prognosis.

Stage 0 (carcinoma/tumor in-situ) non-small cell lung cancer is an early stage of lung cancer that is only in the top lining of the lung or bronchus and has not spread. 

Stage I non-small cell lung cancer (NSCLC) is divided into two sub-stages, 1A and 1B, based on the size of the tumor. In Stage I 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/or have begun to spread to nearby lymph nodes. 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. Most commonly the cancer has spread to the lymph nodes in the mediastinum (the area in the chest between the lungs). 

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, to the lining of the lung or other areas of the body. 

Small Cell Lung Cancer Stages

Small cell lung cancer is described using two stages: limited and extensive. 

Limited stage lung cancer is only in one lung with or without spread to the lymph nodes in the mediastinum (area in the chest between the lungs). 

Extensive stage lung cancer has spread to tissue outside of the originally affected lung like the opposite lung or distant organs.