Lung cancer staging
To plan for best treatment, your doctor needs to know the type of lung cancer and the extent (stage) of the disease. This is why staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body. Staging is typically defined by the location and size of the initial lung tumor, and whether it has spread to lymph nodes or more distant sites (lymph nodes, brain, bones, liver, and/or adrenal glands). Doctor also want to know which type of lung cancer (NSCLC versus small cell) is present in order to determine the type of treatment is needed.
Staging may involve blood tests and other tests:
Bone scan - A bone scan may show evidence of cancer that has spread to the bones. During this procedure, you receive an injection of a small amount of a radioactive substance that travels through the blood and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of your bones on a computer screen or on film.
CT scan - CT scans can visualize cancer that has spread to the liver, adrenal glands, brain, or other organs. Before a CT scan, you may receive contrast material by mouth and by injection into your arm or hand to help these tissues show up more clearly. If a tumor appears on the CT scan, your doctor may order a biopsy to look for lung cancer cells.
MRI - Your doctor may order MRI pictures of your brain, bones, or other tissues. An MRI uses a powerful magnet linked to a computer to create detailed pictures of tissue on a computer screen or film.
PET scan - Your doctor uses a PET scan to find cancer that has spread. During a PET scan, you receive an injection of a small amount of radioactive sugar. A machine makes computerized pictures of the sugar being used by cells in the body. Cancer cells use sugar faster than normal cells, and areas with cancer look brighter on the pictures.
Stages of small cell lung cancer
Doctors describe small cell lung cancer using two stages. The treatment options are different and are based on staging.
Stages of non small cell lung cancer
Doctors describe non-small cell lung cancer based on the size of the lung tumor and whether cancer has spread to the lymph nodes or other tissues:
Occult stage - Lung cancer cells are found in sputum or in a sample of water collected during bronchoscopy, but a tumor cannot be seen in the lung.
Stage 0 - Cancer cells are found only in the innermost lining of the lung. The tumor has not grown through this lining. A Stage 0 tumor is also called carcinoma in situ. The tumor is not an invasive cancer.
Stage 1A - The lung tumor is an invasive cancer. It has grown through the innermost lining of the lung into deeper lung tissue. The tumor is less than 3 centimeters across and is surrounded by normal tissue. The tumor does not invade the bronchus. Cancer cells are not found in nearby lymph nodes.
Stage 1B - The tumor is larger or has grown deeper, but cancer cells are not found in nearby lymph nodes. The lung tumor is one of the following:
- grown into the main bronchus
- grown through the lung into the pleura
- more than 3 centimeters across
Stage 2A - The lung tumor is no more than 3 centimeters across. Cancer cells are found in nearby lymph nodes.
Stage 2B - The tumor is one of the following:
Cancer cells are not found in nearby lymph nodes, but the tumor has invaded the chest wall, diaphragm, pleura, main bronchus, or tissue that surrounds the heart. Cancer cells are found in nearby lymph nodes, and one of the following:
- has grown into the main bronchus
- has grown through the lung into the pleura
- more than 3 centimeters across
Stage 3A - The tumor may be any size. Cancer cells are found in the lymph nodes near the lungs and bronchi, and in the lymph nodes between the lungs but on the same side of the chest as the lung tumor.
Stage 3B - The tumor may be any size. Cancer cells are found on the opposite side of the chest from the lung tumor or in the neck. The tumor may have invaded nearby organs, such as the heart, esophagus, or trachea. More than one malignant growth may be found within the same lobe of the lung. The doctor may find cancer cells in the pleural fluid.
Stage 4 - Malignant growths may be found in more than one lobe of the same lung or in the other lung. Or cancer cells may be found in other parts of the body, such as the brain, adrenal gland, liver, or bone.
Once lung cancer has been staged, you can begin treatment. Treatment of lung cancer will depend on the stage and type of cancer diagnosis and treatment options are plenty. To learn about the most common forms of lung cancer treatments, read on.