Staging and prognosis for lung cancer

Various tests help your specialist work out how far the cancer has spread. This is known as staging, and it helps your health care team recommend the best treatment for you.

Non-small cell lung cancer and small cell lung cancer can both be staged using the TNM system. 

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TNM system

TNM stands for tumour−nodes−metastasis. Each letter is assigned a number (and sometimes also a letter) to show how advanced the cancer is. This information may be combined to give the lung cancer an overall stage of I, II, III or IV. The staging system for lung cancer is complex and often changes, so ask your doctor to explain how it applies to you.



Indicates the size of the tumour and the depth of any tumour invasion into the lung. Ranges from T1a (tumour is less than 1 cm) to T4 (tumour is more than 7 cm, or has grown into nearby structures, or there are two or more separate tumours in the same lobe of a lung).



Shows if the tumour has spread to nearby lymph nodes. Ranges from N0 (no spread) to N3 (cancer in lymph nodes on the opposite side of the chest, above the collarbone or at the top of the lung).



Shows if the tumour has spread to other parts of the body. Ranges from M0 (no spread to distant parts of the body) to M1c (cancer has spread and formed more than one tumour in distant parts of the body, e.g. liver, bone).

Lung cancer by stage

stages I and II

early lung cancer

stage III

locally advanced lung cancer

stage IV

advanced or metastatic lung cancer


Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease. Instead, your doctor can give you an idea about the general outlook for people with the same type and stage of cancer.

To work out your prognosis, your doctor will consider:

  • your test results
  • the type of lung cancer
  • the rate and extent of tumour growth
  • how well you respond to treatment
  • other factors such as your age, fitness and overall health, and whether you’re currently a smoker.

As in most types of cancer, the results of lung cancer treatment tend to be better when the cancer is found and treated early. However, new treatments such as targeted therapy and immunotherapy have been effective in some people with advanced lung cancer. 

Quitting smoking

Many people diagnosed with lung cancer have already stopped smoking, often years before, and some have never smoked at all. If you are a smoker, your doctors will advise you to stop smoking before you start treatment for lung cancer. This is because smoking may make the treatment less effective and side effects worse.

Quitting can be hard, especially if you’re already feeling anxious about the cancer diagnosis, so it is important to seek support. This may include a combination of:

  • counselling, either over the phone, online or face-to-face
  • nicotine replacement therapy (patches, lozenges, gum, sprays or inhalers)
  • medicines that reduce nicotine craving and withdrawal symptoms.

To work out a plan for quitting, talk to your doctor, call Quitline 13 7848 or visit

Click on the icon below to download a PDF booklet on lung cancer.

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Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
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To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
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Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

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Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit
For more information on accessing a PDF on your Kindle™, visit, log in to your account and click on Personal Document Settings.
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Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in November 2018
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