Lung Cancer Stages

Lung cancer begins in a person’s lungs before possibly spreading. The lungs are spongy organs located in the chest that are responsible for taking in oxygen during inhalation and exhaling carbon dioxide. Staging refers to the location of cancer as well as whether and to where the cancer has spread. By knowing the stage, the doctor can decide on the ideal treatment as well as predict the prognosis of the patient more easily.

Symptoms of Lung Cancer

Most of the time lung cancer doesn’t show any signs or symptoms early on. Instead, the symptoms usually begin once the cancer has advanced. These symptoms might include:

  • Headache
  • Bone pain
  • Weight loss (without trying)
  • Hoarseness
  • Wheezing
  • Chest pain
  • Shortness of breath
  • Coughing up even a small quantity of blood
  • Changes to a chronic (or “smoker’s”) cough
  • A new cough which won’t go away

Lung Cancer Stages

The term "stage" refers to the amount to which the lung cancer spread within the body. To determine the stage, a doctor will evaluate the size of the tumor in addition to whether there are metastases within other organs or the lymph nodes. Staging is crucial for determining the ideal treatment for a tumor as well as a patient’s prognosis. Generally speaking, patients with higher-stage tumors will have a worse prognosis compared to those with lower-stage tumors.

Tests to Stage Lung Cancer

Doctors use a combination of tests to stage lung cancer and these include PET scans, bone scans, CT scans, X-rays, and blood tests. Abnormal blood chemistry tests can indicate metastases within the liver or bone. Radiological procedures are also used to determine the size of a tumor in addition to whether it has spread to additional organs.

Non-Small-Cell Lung Cancer

This is the most common type of lung cancer and usually responds differently to various treatments and spreads slower than small-cell lung cancer does. The following chart outlines the stages of non-small-cell lung cancer.


Description of the Cancer

Stage 1

Within stage one, the cancer hasn’t spread to surrounding lymph nodes and remains in the lungs. There are two sub-stages.

Stage 1A: The tumor measures less than 1.2 inches (3 cm) in size.

Stage 1B: The tumor is between 1.2 and 2 inches (3 to 5 cm).

Stage 2

Stage 2A: The tumor is 5 to 7 cm or the tumor is smaller than 5 cm but cancerous cells are in nearby lymph nodes.

Stage 2B: One of the following is true:

  • The tumor is over 7 cm.
  • The tumor is 5 to 7 cm with cancerous cells in nearby lymph nodes.
  • The cancer is not in lymph nodes, but is in surrounding tissue or muscle.
  • The cancer has reached a main airway.
  • The cancer led to the lung collapsing.
  • There are several smaller tumors within the lung.

Stage 3

Stage 3A: In this stage the cancer is either within the lymph nodes located in the center of the chest or it has spread to the surrounding tissue. The surrounding tissue can include the middle chest region, the chest wall, the pleura which covers the lung, or other lymph nodes that are located close to the lung.

Stage 3B: In this stage, the cancer spread to one of the following places:

  • The lymph nodes located above the collarbone on either chest side.
  • Another crucial body part like the heart, windpipe, gullet, or a main blood vessel.

Stage 4

Stage 4 lung cancer means that the cancer is either in both lungs or has entered another area of the body (like the brain, liver, or bones) or that it has led to the buildup of cancer cells that contain fluid in the lungs or heart.

Small-Cell Lung Cancer

This type of lung cancer is less common and involves smaller cancerous cells when they are observed under a microscope. There are only two stages of small-cell lung cancer:

  • Limited Disease means that cancer is only located within the lung.
  • Extensive Disease means that the cancer has spread further than the lung.

Treatments for Lung Cancer

Lung cancer is treated via four basic methods: targeted therapy, chemotherapy, radiation therapy and surgery.

1. Surgery

The surgery aims to remove the complete lung tumor as well as the lymph nodes which are nearby in the chest and the removal must include a surrounding margin of healthy lung tissue. If there is a “negative margin” then no cancer was in the healthy tissue around the tumor. The types of surgery used for lung cancer include radiofrequency ablation, pneumonectomy, segmentectomy, a wedge, or lobectomy.

2. Radiation Therapy

Radiation therapy uses high energy particles such as x-rays to destroy the cancer cells. It can be external-beam radiation therapy which involves using a machine outside of the body. There is usually a specific schedule of treatments. Internal radiation therapy (brachytherapy) is less common for lung cancer and involves using implants. This treatment must focus on a specific part of the body.

3. Chemotherapy

Chemotherapy involves the use of drugs which stop the ability of cancer cells to grow and divide, thereby destroying them. It can help with cancer in any stage. Most of the time chemotherapy to treat lung cancer is via IV but it can also be in the form of an oral pill. The treatment can involve one or several drugs and this depends on the type of lung cancer.

4. Targeted Therapy

Targeted therapy treats the specific proteins, tissue environment or genes of the cancer. It blocks cancer from growing and spreading but also limits damage done to healthy cells. The doctor must first run tests to determine which protein, gene, or other factor to target.

How to Avoid the Worsening of Symptoms

Once diagnosed with lung cancer, you can also take several steps to prevent the symptoms from worsening and help deter the cancer from spreading.

  • Stay away from cigarettes. Don’t start smoking if you have lung cancer and talk to your kids about the risks of smoking. You should also do your best to avoid secondhand smoke by staying away from places with smokers and encouraging those you know to quit.
  • Maintain a healthy diet. Make sure your diet includes fruits and vegetables that contain vitamins and nutrients. Try not to take many vitamins as pills as they can actually increase your risk.
  • Know the cancer. Take the time to learn about your cancer as well as the treatment options. This will give you the ability to make informed decisions.
  • Seek support from family and friends. Create a support network that can provide emotional, physical and practical support, such as taking you to treatments or helping keep your home clean. You can even look for additional emotional help from various groups.
  • Relax and focus. When you feel short of breath, try to relax as anxiety and fear will make it worse. Try listening to music, praying, meditating or imagining your favorite place to relax.

For more information such as symptoms, causes as well as the staging of lung cancer, watch the video below:

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