Lung Cancer Staging

If lung cancer is verified, the tissue obtained for the biopsy will also be examined to determine the type (non-small cell or small cell) and stage of cancer. The lower the staging number, the less advanced the cancer.

Staging is important for creating the best treatment plan. It also helps determine if the cancer has possibly spread to the lymph nodes, brain, bones, liver, adrenal glands and/or other areas of the body.

There are two staging systems: clinical and pathologic. The clinical stage is based on information obtained before any surgery involving resection of lung tissue. This information is obtained from the biopsy (which may include a bronchoscopy and mediastinoscopy), imaging tests and physical exams. The pathologic stage uses the same information found in the clinical stage but adds information discovered as a result of the definitive surgical resection.

Additional tests may be required to help determine the cancer stage:

  • PET Scan: These scans use more sophisticated techniques to determine if the cancer has spread to other parts of the body that may not be apparent on a CT scan.
  • Bone Scan: This is a nuclear scanning test to find abnormalities in the bone and helps show if cancer has spread to the bones. Nuclear scans use small amounts of low-energy radioactive substances to detect cancers.
  • MRI: Magnetic resonance imaging (MRI) produces detailed images of organs and soft tissues, and can pinpoint the exact location and size of a tumor. MRIs help show if cancer has spread to the brain or other organs.

Stage         WHAT IT MEANS
Occult Stage Cancer cells are found in the sputum or in the sample of cells collected during a bronchoscopy but a tumor is not seen in the lung.
Stage 0 Cancer cells are found in only a few layers of cells and have not grown beyond the lung's inner lining. A Stage 0 tumor is called carcinoma in situ.
Stage IA All Stage I lung cancers are contained within the lung and cancer cells are not found in the lymph nodes. In Stage IA, the tumor is invasive and has grown through the inner lining into the deeper tissue of the lung. The tumor does not exceed three centimeters. Tissue surrounding the tumor is normal.
Stage IB Tumor is larger than three centimeters but less than 5 cm and has grown deeper. It may have grown into the bronchus or through the lung into the pleura. Cancer is not in the lymph nodes.
Stage IIA Tumor is less than 5 cm and cancer cells may be in nearby lymph nodes. The tumor has not invaded the bronchus and it has not spread to other areas of the body.
Stage IIB The cancer is 5 to 7 cm and involves hilar lymph nodes, or invades surrounding structures, or has other masses in the same lobe.
Stage IIIA Cancer cells are found in same side mediastinal lymph nodes. An additional lung mass in another lobe on the same side. The tumor can be any size.
Stage IIIB Cancer cells are found in lymph nodes in the neck or on the other side of the chest from where the tumor is located. Cancer is quite extensive to surrounding structures. The tumor can be any size. An additional lung mass in another lobe on the same side.
Stage IV Tumor mass is found in the other lung. Cancer may have spread to other areas of the body like the bones, liver or brain.

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