These tests will show what type of lung cancer you have and how far it has spread. Called staging, this helps your doctors recommend the best treatment for you.
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Lung cancer by stage
Both NSCLC and SCLC are staged using a system that considers the size of the tumour, whether it has affected lymph nodes and whether it has spread. This is called the tumour–nodes–metastasis (TNM) system. Sometimes, SCLC is staged using a different system. For more information about these 2 staging systems see the tables below.
TNM staging system
TNM stands for tumour–nodes–metastasis. Each letter is given a number (and sometimes another letter) to show how advanced the cancer is. This information may be combined to give the lung cancer an overall stage of 1, 2, 3 or 4.
| T (tumour) | indicates the size of the tumour and how far the tumour has grown into the lung; ranges from T1a (tumour is 1 cm or less) to T4 (tumour is more than 7 cm, or has grown into nearby vital structures, or there are two or more separate tumours in the same lung). |
| N (nodes) | 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) |
| M (metastasis) | 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) |
Staging SCLC
Sometimes, SCLC is staged using a 2-stage system in which the cancer is classified as either limited stage or extensive stage.
| limited stage | cancer is only on one side of the chest and in one part of the lung; nearby lymph nodes may also be affected. |
| extensive stage | Cancer has spread widely through the lung, to the other lung, to lymph nodes on the other side of the chest or to other areas in the body. |
Prognosis
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 lung cancer.
To work out your prognosis, your doctor will consider:
- your test results
- the type and stage of lung cancer
- the rate and extent of tumour growth
- other factors such as your age, fitness and overall health, and whether you smoke.
Discussing your prognosis and thinking about the future can be challenging and stressful. It is important to know that although the statistics for lung cancer can be frightening, they are an average and may not apply to your situation. Talk to your doctor about how to interpret any statistics that you come across.
As in most types of cancer, the results of lung cancer treatment tend to be better when the cancer is found and treated early. Newer treatments such as targeted therapy and immunotherapy are having good results in some people with advanced lung cancer and are bringing hope to those who have lung cancer that has spread.
In the future, these therapies may also be used in earlier stage cancer. For more on this see Targeted therapies and Immunotherapy.
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A/Prof Brett Hughes, Senior Staff Specialist Medical Oncologist, Royal Brisbane and Women’s Hospital, The Prince Charles Hospital and The University of Queensland, QLD; Dr Brendan Dougherty, Respiratory and Sleep Medicine Specialist, Flinders Medical Centre, SA; Kim Greco, Nurse Consultant – Lung Cancer, Flinders Medical Centre, SA; Dr Susan Harden, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; A/Prof Rohit Joshi, Medical Oncologist, GenesisCare and Lyell McEwin Hospital, Director, Cancer Research SA; Kathlene Robson, 13 11 20 Consultant, Cancer Council ACT; Peter Spolc, Consumer; Nicole Taylor, Lung Cancer and Mesothelioma Cancer Specialist Nurse, Canberra Hospital, ACT; Rosemary Taylor, Consumer; A/Prof Gavin M Wright, Director of Surgical Oncology, St Vincent’s Hospital and Research and Education Lead – Lung Cancer, Victorian Comprehensive Cancer Centre, VIC.
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