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.
Learn more about:
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).|
|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.
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:
To work out a plan for quitting, talk to your doctor, call Quitline 13 7848 or visit quitnow.gov.au.
Dr Henry Marshall, Thoracic Physician, The University of Queensland Thoracic Research Centre, The Prince Charles Hospital, QLD; Dr Naveed Alam, Thoracic Surgeon, St Vincent’s Melbourne and Epworth Richmond Hospitals, VIC; A/Prof Martin Borg, Radiation Oncologist, GenesisCare, SA; Dr Lisa Briggs, Consumer; Kirsten Mooney, Thoracic Cancer Nurse Coordinator, WA Cancer & Palliative Care Network, WA; Claire Mulvihill, Lung Cancer Support Nurse, Lung Foundation Australia; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; A/Prof Nick Pavlakis, President, Australasian Lung Cancer Trials Group, President Elect, Clinical Oncology Society of Australia, and Senior Staff Specialist, Department of Medical Oncology, Royal North Shore Hospital, NSW. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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