Introduction to the Staging of Lung Cancer

by Elizabeth Lynette Perkins

Posted on Wednesday 27th of July 2011

Lung cancer (LC) starts as a small group of malignant cells that can spread from your lungs to other areas of your body. After the condition has been conclusively diagnosed, it is defined by a stage. The stage of the disease dictates the form of treatment and therapy needed to eliminate the cancerous cells. Staging is also helpful for forecasting the chances of survival.

In this article, we'll provide a summary of lung cancer staging. You'll learn the extent to which the cancerous cells metastasize as the disease progresses.

Stage 0

This stage is also called carcinoma in situ. A tumor exists, but has not spread past the inner lining of the lung. The survival rate is extremely high if the disease can be identified and treated while in this early stage. Sadly, LC is rarely detected this early. Treatment is almost always done through surgery since the diseased cells are localized.

Stage 1

The disease is still contained within the lung and has not yet metastasized to the patient's lymph nodes. Stage 1 is further categorized into stages 1A and 1B. The former refers to tumors that are smaller than 3 centimeters. The latter refers to those that are larger.

It is estimated that approximately 30% of non-small cell LC cases are diagnosed while in this stage or stage 2. Surgery is still the preferred treatment option and is often performed through a minimally invasive technique involving video-assisted thoracoscopic surgery (VATS). There are occasions when stage 1 lung cancer is inoperable. In such cases, radiation therapy is used to manage the symptoms and slow the cancer's growth.

Stage 2

By this point, the disease has usually spread into the patient's lymph nodes within the main bronchus. This stage is categorized into stages 2A and 2B. As before, the size of the tumor dictates the categorization. 2A refers to tumors that are smaller than 3 centimeters; 2B refers to those that are larger. Because the cancerous cells are still localized, surgery is used to remove the diseased tissue. If the tumor is located in an area of the lung that makes it difficult to treat with surgery, an oncologist will recommend radiation therapy.

Stage 3A And 3B

In stage 3A, the tumor has spread outside the lung to the lymph nodes in the tracheal area. Most have also grown in size. At this point, the patient's symptoms might include persistent infections such as bronchitis as well as chest pain, breathing difficulties, and coughing up blood.

Nearly 10% of patients who are diagnosed with non-small cell lung cancer are at stage 3A. Unfortunately, the survival rate drops sharply for these patients. While surgery is performed, it is rarely sufficient for eliminating the cancerous cells. Chemotherapy is usually required.

Stage 3B defines lung cancer that has spread throughout the chest. It can be treated, but is rarely curable. Nearly 20% of patients are diagnosed with LC at this stage. Chronic fatigue, swallowing difficulties, and weight loss are common.

Because the disease is inoperable by stage 3B, treatment comes in the form of chemotherapy and radiation therapy. Patients can also elect to volunteer for clinical trials.

Stage 4

This stage is the most advanced with the tumor having spread to other parts of the body. Lung cancer at this point is incurable, even with aggressive chemotherapy. For this reason, many patients opt to undergo clinical trials to improve their chances of survival and prolong their life. The survival rate among patients with this stage of the disease drops to 10%.

The staging above clarifies why it is so important to diagnose and begin treating lung cancer as early as possible. By the time the disease has reached stage 3B, surgery, including minimally invasive VATS lobectomies, are no longer an option.

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