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Cancer

Non-Small Cell Lung Cancer: Stages

What does stage of a cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

What are the stages of non-small cell lung cancer?

The stage of non-small cell lung cancer (NSCLC) is based on these things:

  • Size and extent of your tumor

  • Whether lymph nodes are involved and, if so, how many

  • Whether the cancer has spread to other parts of your body

The stages of NSCLC are described using the TNM staging system.

The TNM system

The TNM system is a standard system for describing how much a cancer has spread. Here's what the letters stand for in the TNM system:

  • T tells how large a tumor is and whether it has grown into nearby structures.

  • N tells whether the lymph nodes near the tumor are cancerous.

  • M tells whether the cancer has spread (metastasized) to other organs in the body, such as your brain, bones, or liver.

Numbers are assigned to each of the T, N, and M categories. Once your doctor has determined your T, N, and M categories, he or she uses this information in a process called stage grouping. Stage grouping is used to find out your overall disease stage.

Stage groupings

These are the stages of non-small cell lung cancer. Each TNM category has a number value from X to 4. It falls into one of these stages:

  • Occult. This means you have cancer cells in your sputum (mucus from the lungs) or other lung fluids. At this stage, the tumor in your lungs cannot be seen. You may hear your doctor use these TNM terms for this stage: TX, N0, M0.

  • Stage 0. In this stage, cancer is only in the cells lining your air passages. The cancer is very tiny. It has not invaded deeper into lung tissues or spread outside the lungs. Cancer at this stage is also called carcinoma in situ. You may hear your doctor use these TNM terms for this stage: Tis, N0, M0.

  • Stage I. In this stage, you have cancer in your lung, and it may affect your airways (bronchi) or the lining outside your lung. Cancer found at this stage usually offers a good chance of survival. Stage I is divided into Stage IA and IB, based on the size and location of the tumor. For Stage IA, your doctor may use these TNM terms: T1, N0, M0. For Stage IB, your doctor may use these TNM terms: T2a, N0, M0.

  • Stage II. In this stage, the cancer may have spread into surrounding tissue. You may have cancer in your lymph nodes within your lung on the same side the cancer is in. Stage II is divided into Stage IIA and IIB, based on the size and location of the tumor and whether it has spread to the lymph nodes. For Stage IIA, your doctor may use these TNM terms: T1, N1, M0 or T2a, N1, M0 or T2b, N0, M0. For Stage IIB, your doctor may use these TNM terms: T2b, N1, M0 or T3, N0, M0.

  • Stage III. Stage III is divided into two substages: Stage IIIA and Stage IIIB. In Stage IIIA, the cancer may have spread to the organs or lymph nodes in the middle of the chest (mediastinum). Or it may have spread into a different lobe in the same lung. It may also have spread to lymph nodes behind your windpipe (trachea). For Stage IIIA, you may hear your doctor use these TNM terms: T1-T3, N2, M0 or T3, N1, M0 or T4, N0-N1, M0. In Stage IIIB, the cancer has spread to the lymph nodes above your collarbone on either side or to the lymph nodes on the other side of your chest. Or it has grown into the middle part of the chest or into a different lobe of the same lung, as well as into lymph nodes in the middle of the chest. For Stage IIIB, you may hear your doctor use these TNM terms: Any T, N3, M0 or T4, N2, M0.

  • Stage IV. In Stage IV, the cancer has spread to the other lung, into the fluid around the lung or heart, or to other distant organs in your body such as the liver or brain. You may hear your doctor use these TNM terms for this stage: Any T, any N, M1a-M1b.

Talking with your healthcare provider

Once your cancer is staged, your health care provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.

Online Medical Reviewer: Alteri, Richard, MD
Online Medical Reviewer: Gersten, Todd, MD
Date Last Reviewed: 1/3/2016
© 2013 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.
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