Staging of lung cancer
This information is an extract from the booklet Understanding
lung cancer. You may find the full booklet helpful. We can
send you a free copy – see page 4.
Contents
• Cancer staging
• Staging of small cell lung cancers
• Staging of non-small cell lung cancers
Cancer staging
The stage of a cancer describes its size, position and whether it has spread beyond where it started in the body.
Knowing the extent of the cancer helps the doctors decide on the most appropriate treatment.
Generally, cancer is divided into four stages:
•Stage 1 The cancer is small and localised.
•Stages 2 or 3 The cancer has spread into surrounding areas.
•Stage 4 The cancer has spread to other parts of the body.
If the cancer has spread to distant parts of the body, this is
known as secondary or metastatic cancer. If the cancer comes
back after initial treatment it’s known as recurrent cancer.
Lung cancer staging
The current staging system is used for both small cell and non-small cell lung cancers. This aims to help doctors plan the best treatment for people with lung cancer. It can also help to give an idea of the likely outcome of treatment.
We have a fact sheet about the current staging system,
which we can send you.
Questions about cancer? Ask Macmillan 0808 808 00 00 www.macmillan.org.uk
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Staging of lung cancer
Staging small cell lung cancers
Although the current staging system is for both non-small cell and small cell lung cancers, there is another system that
has been used for many years, which you may hear your
doctors refer to. This system divides small cell lung cancers into two stages:
Limited disease – the cancer cells can be seen only in
one lung, in nearby lymph nodes, or in fluid around the lung (known as a pleural effusion).
Extensive disease – it’s clear that the cancer has spread
outside the lung, within the chest area or to other parts of the body.
Small cell lung cancer often spreads outside the lung quite early on. Even if the doctor can’t see any evidence of the
spread on your scans, it’s likely that some cancer cells will have broken away and travelled through the bloodstream or lymphatic system. To be safe, small cell lung cancers are
usually treated as though they have spread, whether any
secondary cancer can be seen or not.
Staging non-small cell lung cancer
Non-small cell lung cancer is usually divided into four stages.
Stage 1
The cancer is very localised and hasn’t spread to the lymph
nodes. This stage is divided in two:
•Stage 1A The cancer is no bigger than 3cm in size.
•Stage 1B The cancer is larger than 3cm, or is growing
into the main airway of the lung (bronchus). The cancer may also have spread to the membrane covering the lung (pleura), or has made the lung partially collapse.
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Questions about cancer? Ask Macmillan 0808 808 00 00 www.macmillan.org.uk
Staging of lung cancer
Stage 2
Stage 2 cancer is also divided in two:
•Stage 2A The cancer is small and measures 3cm or less,
and affects nearby lymph nodes.
•Stage 2B Either the cancer is larger than 3cm and in the
nearby lymph nodes; or there is no cancer in the lymph
nodes but the tumour has made the lung collapse; or it has grown into the:
•chest wall
•membrane covering the lung (pleura)
•muscle layer below the lungs (diaphragm)
•covering of the heart (pericardium).
Stage 3
Stage 3 cancer is also divided in two:
•Stage 3A The cancer is any size and has spread to the
lymph nodes in the middle of the chest (mediastinum), but not to the other side of the chest; or the cancer has
spread into tissue around the lung near to where it started.
This can be into:
•the chest wall
•the covering of the lung (pleura)
•the middle of the chest (mediastinum)
•other lymph nodes close to the affected lung.
•Stage 3B The cancer has spread to:
•lymph nodes on either side of the chest or above the collarbone
•another major structure such as the gullet
(oesophagus), the heart, windpipe (trachea) or to a main blood vessel; or there may be two or more tumours in the same lung or a collection of fluid containing cancer cells around the lung
(pleural effusion).
Stage 4
The cancer has spread to a distant part of the body such as the liver, bones or the brain.
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Staging of lung cancer
More information and support
Cancer is the toughest fight most of us will ever face. But you
don’t have to go through it alone. The Macmillan team is
with you every step of the way, from the nurses and therapists
helping you through treatment to the campaigners improving
cancer care. We are Macmillan Cancer Support.
To order a copy of Understanding lung cancer or
one of the other booklets or fact sheets mentioned
in this information, visit be.macmillan.org.uk or call
0808 808 00 00.
We make every effort to ensure that the information we provide is accurate but it
should not be relied upon to reflect the current state of medical research, which is
constantly changing. If you are concerned about your health, you should consult
your doctor. Macmillan cannot accept liability for any loss or damage resulting from
any inaccuracy in this information or third party information such as information on
websites to which we link. © Macmillan Cancer Support 2012. Registered charity
in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604).
Registered office 89 Albert Embankment, London, SE1 7UQ
REVISED IN OCTOBER 2012
Planned review in 2014
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Questions about cancer? Ask Macmillan 0808 808 00 00 www.macmillan.org.uk