The stage of cancer describes how far the disease has spread. Therefore your treatment and prognosis (outlook) depends on how advanced the disease is. The stage of your lung cancer also tells you the following:
- Where cancer cells or a tumor are in your lungs
- If your cancer is in one spot or has spread
- How large your tumor currently is
Types Of Lung Cancer
There are two main types of lung cancer: non-small cell and small cell. Each type has different stages. Non-small cell lung cancers take their names and classifications based on the types of cells within the tumor. These cancer types tend to grow slowly.
Small cell lung cancer (SCLC) is particularly aggressive. It begins and spreads rapidly. Only around 15 percent of lung cancers are small cell lung cancer.
What Is The TNM System?
When your doctor discusses lung cancer staging, he/she often uses the letters T, N, and M.
- T indicates the size of your tumor. It also denotes its location in your lungs or your body.
- N indicates node involvement. Node involvement means whether or not your cancer has spread to your lymph nodes in your lung area.
- M indicates metastasis and relates to whether or not your cancer has spread. Sometimes lung cancer can spread to other organs and parts of your body such as your other lung, bones, liver, kidneys, brain and adrenal glands.
Your doctor uses the above letters to stage your tumor and will then be more specific by adding numbers between zero and four. Your doctor measures your tumor in centimeters to give it a number. The higher the number, the more your tumor has spread or grown. Sometimes your physician puts X in the place of a number. This means that the doctor cannot measure the mass and it’s not clear as to how far it’s spread.
Non-Small Cell Lung Cancer Stages
A way to accurately describe non-small cell lung cancer (NSCLC) is by its pathologic or clinical stage. Your physician may carry out a biopsy where he/she takes a small piece of tissue from your tumor and studies this under a microscope. You may also have imaging scans that take pictures of the inside of your body.
If you have surgery for cancer, your physician can check the pathologic stage of your cancer. This lets your doctor know how far the cancer has spread or grown. The usual way to stage NSCLC tumors is via the TNM system. The letter and number combinations describe the following:
- If there is more than one single tumor on the same lung.
- The tumor width in centimeters or whether it’s too small to measure.
- The location of the tumor in your lung.
- If the tumor has spread to other organs or lymph nodes.
- If you have blocked or clogged airways that could potentially cause pneumonia or a collapsed lung.
Your treatment team may also speak of the following general NSCLC stages:
- Occult stage - Your tumor can’t be seen in a biopsy or imaging scans but is present in the mucus you cough up. The occult stage is also known as hidden cancer.
- Stage 0 - Your tumor is small. Cancer cells have not spread to deep lung tissue or out with your lungs.
- Stage l - Cancer is not in your lymph nodes but is present in your lung tissues.
- Stage ll - Cancer may have spread to the lymph nodes close to your lungs.
- Stage lll - The cancer has progressed further into your lymph nodes and into the middle of your chest.
- Stage lllA - Cancer is in your lymph nodes. It’s confined to the same side of the chest where it began to grow initially.
- Stage lllB - The cancer has now spread to the lymph nodes on the other side of your chest or to the ones above your collarbone.
- Stage lV - The disease has spread around your body. It could be in your liver, brain or bones.
Small Cell Lung Cancer Stages
Your doctor may use the TNM system if you have this type of cancer. He/she then will put them
Disease into one of the two following main stages:
- Limited stage - At this point, the cancer is only in one lung and potentially the nearby lymph nodes. It has not reached your other lung or anywhere else.
- Extensive stage - Your tumor has spread to other areas of your chest and lungs. It could also be potentially found in the fluid around your lungs or in other organs such as your brain.
Early Symptoms of Lung Cancer
If you have any of the following symptoms, it’s worth having a talk with your doctor. Bear in mind that each of the following can be symptoms of a variety of illnesses:
- Lingering or worsening cough
- Shortness of breath
- Chest pain that worsens as you cough, breathe deeply or laugh
- Weight loss
- Lack of appetite
- Recurrent respiratory infections such as bronchitis or pneumonia
Remember that although anyone can get lung cancer, the American Lung Association has stated that 90 percent of lung cancers relate to smoking. Other causes of the disease include radon exposure and breathing in other hazardous substances, such as:
- Some petroleum products
Malignant mesothelioma is another type of lung cancer that is virtually always caused by asbestos exposure.
There are many treatments available for the various stages of lung cancer today. Your lung cancer treatment team will discuss the specific ones for your type and stage of lung cancer.
Screening for Lung Cancer
Most patients are first diagnosed with lung cancer based on symptoms. They must then undergo a variety of tests to confirm and gain more information. Imagine, pathology and biopsies may be performed before an official and complete diagnosis is given and a treatment plan formed.
However, this is steadily changing. Modern research is looking for less complicated and expensive screenings, such as breath and saliva analysis. Currently, the American Society of Clinical Oncologists recommends annual screening with low-dose computed tomography for both smokers and former smokers, as they are at high risk for lung cancer. Yearly LCDT scanning is recommended after discussion with your primary care physician if you are high-risk. To be considered high-risk, one typically must align with the following:
- Being between ages 55-74
- Having smoked for 30+ years
- Currently smoking
- Having smoked within the last 15 years