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.

The stage is determined by:

  • The size of the tumor
  • Its relation to surrounding organs
  • The presence or absence of spread to the lymph nodes
  • If there is nodal spread, which lymph nodes are involved
  • Whether the tumor has spread to other solid organs inside or outside of the chest

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