Your doctor may strongly suspect you have lung cancer, or found you have it. The next step is to describe the cancer, such as the size of a tumor and if it has spread. This description is called the cancer stage. MSK’s thoracic (lung) surgeons, lung specialists, and radiologists will define your stage as quickly as possible. They will plan diagnostic procedures that will let them learn the stage of the cancer.
Staging is based on:
- The size and location of the original tumor (also called the primary tumor)
- Whether the cancer has metastasized (spread) to nearby lymph nodes
- Whether the cancer has metastasized (spread) to other organs
Staging is an important step in choosing the best treatment for you. The stage of your cancer also helps doctors predict the outcome (result) of your treatment. To do this, we may recommend you have more tests, including imaging or biopsies.
Imaging tests to help learn the cancer stage include:
- Computed tomography (CT) scans
- Positron emission tomography (PET)/CT scans
- Magnetic resonance imaging (MRI) of the brain
Doctors use the same staging system for both non-small cell and small cell lung cancer. Small cell lung cancer usually is diagnosed at a later stage than non-small cell lung cancer. It often is diagnosed at stage 3 or 4.
Stages of Lung Cancer
Stage 1
In stage 1, the tumor is only in the lung. It is bit small (4 centimeters or less). It has not spread to nearby lymph nodes or outside the chest. Most stage 1 tumors are treated with surgery.
We offer patients who cannot have surgery radiation therapy instead. Most stage 1 patients do not need chemotherapy, targeted therapy, or immunotherapy.
MSK’s experts were among the first to offer minimally invasive surgery to treat early-stage lung cancer. We now use this method with 8 out of 10 people who have stage 1 non-small cell lung cancer. Minimally invasive surgery uses small incisions (cuts) and few stitches, with less damage to nearby tissue.
Stage 2
In stage 2 lung cancer, there are larger tumors (more than 4 centimeters). Or, there are signs the cancer has spread to nearby lymph nodes, but not outside the lung. We usually treat stage 2 lung cancer with surgery, followed by chemotherapy and targeted therapies or immune therapies. We often offer patients who cannot have surgery chemotherapy and radiation instead.
Stage 3
In stage 3 lung cancer, there is cancer in lymph nodes of the chest further away from the lung. Or, there may be large tumors that spread to nearby lymph nodes. Most people with stage 3 cancer have several kinds of treatment. This includes some combination of chemotherapy, surgery, radiation, targeted therapies, and immune therapies.
Stage 4
In stage 4 lung cancer, there is cancer outside the chest cavity where it started. The most common areas are the other lung, bones, brain, and the adrenal gland (a gland on top of the kidneys). Treatment depends on the tumor. It can include chemotherapy, targeted or immune therapies, or a combination.
Treatment Expertise for All Stages
MSK led the way in setting the standard of care for treating every stage of cell lung cancer. Doctors everywhere follow best practices developed at MSK. For example, MSK led a large research study that showed the standard treatment for stage 1 non-small cell lung cancer should be a lobectomy. In this procedure, a complete lobe of the lung is removed. There are 3 lobes in the right lung and 2 in the left. MSK also helped determine the best time to give chemotherapy to people who have stage 2 and 3 cancer.
How long do you live with stage four lung cancer? When people ask that question, I think, I remember the time when I first saw the statistics on Google about stage four lung cancer and how scared I felt when I looked at the numbers. Over the years I’ve learned that it’s about how you interpret statistics rather than the numbers itself.
Numbers may be low, but they may also represent what was available at the time in terms of treatment, and because statistics represent numbers from years ago, and knowing now that there are so many new advancing research, advancing therapies that are improving the outcomes of stage four lung cancer, I know that those statistics are changing and it’s so important to keep that in mind when you look at the numbers.
I’ve lived now with stage four lung cancer for more than five years, and over the years I’ve seen so many stories, so many patients experiences that defy statistics, so remember that, and if you need help, if you want support, please reach out to your medical team and to Lung Foundation Australia. There are more details below. Lung Cancer Search and Rescue. Hope in every breath.