Lung Cancer

Staging

Finding Out How Far Cancer Has Progressed

Once lung cancer has been found, it is usually staged. Staging means determining how far the cancer has progressed.

Through staging, the doctor can tell if the cancer has spread and, if so, to what parts of the body. Lung cancer often spreads to the brain or bones. Knowing the stage of the disease helps the doctor plan treatment.

Staging Small Cell and Non-Small Cell Lung Cancer

There are many types of lung cancer, but the two main types are "small cell" and "non-small cell." Small cell lung cancer is generally faster growing than non-small cell, but small cell is more likely to respond to chemotherapy.

Small cell lung cancer is divided into two types depending on how the cells look under a microscope:

  • small cell carcinoma (oat cell cancer)
  • combined small cell carcinoma.

Non-small cell lung cancer is divided into four stages, I-IV. Most patients with stage I and II non-small cell tumors and some patients with stage III tumors can undergo surgery with the goal of cure.

Stage IV denotes cancer that has spread to other sites in the body, most often bone, brain, or liver. Most stage IV cancers cannot be cured, although treatment may be available to help prolong life.

Tests To Stage Lung Cancer

Here are some tests doctors use to stage lung cancer:

  • Computed tomography, or CT scan, is a computer linked to an x-ray machine that creates a series of detailed pictures of areas inside the body.
  • Magnetic resonance imaging, or MRI, is a powerful magnet linked to a computer that makes detailed pictures of areas inside the body.
  • Radionuclide scanning uses a mildly radioactive substance to show whether cancer has spread to other organs, such as the liver.
  • A bone scan uses a small amount of a radioactive substance to show whether cancer has spread to the bones.
  • A mediastinoscopy or mediastinotomy can help show whether the cancer has spread to the lymph nodes in the chest by removing a tissue sample. The patient receives a general anesthetic for this procedure.