Lung Cancer Stages

As with other forms of cancer, staging for lung cancer involves determining how much cancer there is in the body and exactly where the cancer is located. Staging lung cancer is critical for doctors to determine the best possible course of treatment with the greatest chance of success.

MD Anderson Cancer Center at Cooper’s specialists have the expertise to accurately diagnose lung cancer, determine its stage, and provide advanced treatment options to get your life back to normal as quickly as possible.

Lung Cancer Stage   Treatment
Stage 0 Abnormal cells are located in the top lining of the cells of the lungs; the cancer has not spread to the inner tissues of the lungs or elsewhere in the body. Surgery or laser therapy
Stage I Tumor is small and present in the lungs only (has not spread to the lymph nodes) Surgery possibly followed by chemotherapy or radiation for any remaining traces of cancer
Stage II Tumor (or tumors) are small and may have spread to the lymph nodes but not to other parts of the body Surgery, chemotherapy, or radiation
Stage III Tumors are a bit larger and cancer has spread to lymph nodes but not to other parts of the body Chemotherapy, radiation, immunotherapy, targeted therapy, possibly surgery
Stage IV Cancer has spread (metastasized) from the lungs to distant parts of the body Chemotherapy, radiation, immunotherapy, targeted therapy, possibly surgery

Non-Small Cell Lung Cancer

Non-small cell lung cancers account for approximately 85% of all lung cancers and is the most common form of lung cancer in both men and women as well as smokers and non-smokers. There are several types of non-small cell lung cancer, including adenocarcinoma, squamous cell carcinoma, and large cell or undifferentiated carcinoma. Smoking represents the most significant risk factor for developing lung cancer. For non-smokers, non-small cell lung cancer can be caused by exposure to secondhand smoke, asbestos, and other materials in the workplace.

How Is Non-Small Cell Lung Cancer Diagnosed?

A lung cancer diagnosis will likely begin with imaging tests like a chest X-ray, computed tomography (CT) or a magnetic resonance imaging (MRI) scan. These imaging tests allow your doctor to check your lungs and the areas surrounding them for any abnormalities. If an imaging test points to cancer, your doctor may recommend a biopsy and other tests to confirm a lung cancer diagnosis, determine the stage of the cancer, and develop an appropriate treatment plan.

Occult Stage

The earliest stage of lung cancer, the occult – or hidden – stage of non-small cell lung cancer cannot be seen in any imaging or other tests. At the occult stage, the cancer has not likely spread to the lymph nodes or other parts of the body. This stage of lung cancer may also be called carcinoma in situ.

Stage 0

In stage 0 non-small cell lung cancer, abnormal cells are found only in the outer lining of the cells of the lungs. The cancer hast not spread to the inner tissues of the lungs, the lymph nodes, or anywhere else in the body. Stage 0 non-small cell lung cancer is typically treated with surgery.

Stage I

In stage I non-small cell lung cancer, a tumor (or tumors) is small and has not spread beyond the lungs to the surrounding lymph nodes or other parts of the body. This stage of lung cancer is divided into two substages, IA and IB, depending on the size of the tumor. In stage IA lung cancer, the tumors are less than 3 centimeters (cm) in size, while in stage IB the tumors are larger than 3 cm but less than 4 cm in size.

The symptoms of stage I lung cancer may include:

  • Persistent or worsening cough
  • Coughing up blood or blood-streaked mucus
  • Hoarseness
  • Pain in the chest, rib or shoulder
  • Weight loss
  • Fatigue
  • Lung infections like bronchitis that don’t improve with treatment or come back

Surgery is the primary treatment approach for stage I lung cancer, possibly followed by chemotherapy and radiation if any traces of cancer remain after surgery. If detected and treated early, stage 1 lung cancer tends to be highly curable, with a five-year survival rate between 70-92%.

Stage II

In stage II non-small cell lung cancer, the tumors are small and may or may not have spread to the surrounding lymph nodes. This stage of lung cancer is divided into two substages, IIA and IIB, depending on the size of the tumor and whether the cancer has spread to the lymph nodes. In  stage IIA lung cancer, the tumors are more than 4 cm but less than 5 cm in size and the cancer has spread to the surrounding lymph nodes. In stage IIB cancer, the main tumor is larger than 5 cm but less than 7 cm in size and has not spread to the surrounding lymph nodes.

The symptoms of stage II lung cancer may include:

  • Persistent cough
  • Coughing up blood or blood-streaked mucus
  • Shortness of breath or wheezing
  • Lung infections like bronchitis or pneumonia that don’t improve with treatment
  • Hoarseness
  • Pain in the chest
  • Weight loss
  • Fatigue

Stage II lung cancer is typically treated with surgery, chemotherapy, and radiation. The five-year survival rate is approximately 60% for stage IIA and 53% for stage IIB.

Stage III

In stage III lung cancer, the tumors are larger and have spread to lymph nodes but not to distant parts of the body. This stage of lung cancer is divided into three substages – IIIA, IIIB, and IIIC – depending on the size of the tumor and the specific lymph nodes the cancer has spread to. In stage IIIA, the cancer has spread to the lymph nodes near the tumor, while in stage IIIB the cancer may have spread to the lymph nodes around the collarbone or on the other side of the chest and to other nearby tissues. In stage IIIC, the cancer has spread to the lymph nodes around the collarbone or to the other side of the chest and at least one more tumor is found in either lobe of the lungs.

The symptoms of stage III lung cancer may include:

  • Persistent cough
  • Coughing up blood or blood-streaked mucus
  • Shortness of breath or wheezing
  • Hoarseness
  • Pain in the chest
  • Weight loss
  • Fatigue

Stage III lung cancer is typically treated with chemotherapy, radiation, immunotherapy, targeted therapy, and possibly surgery. Stage III cancer is more advanced and therefore more challenging to treat. The five-year survival rate is approximately 33% for stage IIIA, 26% for stage IIIB, and 13% for stage IIIC lung cancer.

Stage IV

In stage IV lung cancer, the cancer is present in both lung, the fluid around the lungs or the heart and has spread to other parts of the body – primarily the bones, liver, brain, and kidneys. This stage of lung cancer is divided into two categories, IVA and IVB, based on where in the body the cancer has spread to. In stage IVA, the cancer has spread within the chest and an area outside of the chest. In stage IVB, the cancer has spread outside of the chest and affected at least one other organ in the body.

The symptoms of stage IV lung cancer may include:

  • Persistent cough
  • Coughing up blood or blood-streaked mucus
  • Shortness of breath or wheezing
  • Hoarseness
  • Pain in the chest
  • Weight loss
  • Fatigue

Approximately 57% of all lung cancers are diagnosed as stage IV. Treatment may include chemotherapy, radiation, immunotherapy, targeted therapy, and possibly surgery. There is no cure for stage IV lung cancer and the five-year survival rate is approximately 6%.

Small Cell Lung Cancer

Small cell lung cancer accounts for about 15% of all lung cancers and tends to grow much more quickly to other parts of the body – like the liver, bone, and brain – than non-small cell lung cancer. Small cell lung cancer is staged  as either limited or extensive.

Limited Stage

Limited stage small cell lung cancer is present in only one part the chest. This form of lung cancer is usually treated with radiation therapy.

Extensive Stage

Extensive stage small cell lung cancer has spread from its original source to other parts of the body, which may include the fluid around the lungs, the other lung, the bones, and the brain. This form of lung cancer is usually treated with chemotherapy and perhaps immunotherapy, possibly followed by radiation therapy.

Why Choose MD Anderson at Cooper for Lung Cancer Care?

By choosing MD Anderson at Cooper, you have access to specialists and advanced diagnostic and treatment approaches for lung cancer – all right here in South Jersey. As a partner with MD Anderson Cancer Center, one of the nation’s leading cancer center, MD Anderson at Cooper offers:

  • Advanced diagnostics: MD Anderson at Cooper has access to the imaging and biopsies techniques as well as other tests to ensure you receive an accurate diagnosis that will serve as the cornerstone of your unique treatment plan.
  • Expertise in treatments: The experience and expertise of MD Anderson at Cooper’s cancer experts means you have access to cutting-edge therapies to more effectively treat your lung cancer.
  •  Care from a multidisciplinary team: We provide thorough and comprehensive cancer care by tapping into the expertise of a variety of specialists, including oncologists, surgeons, pulmonologists and other specialists.
  • Help in navigating your cancer journey: A dedicated nurse navigator is available to help guide you through every step of your cancer journey.
  • Array of support services: Our team includes nutritionists, complementary medicine therapist, social workers, tobacco cessation counselors and other supportive care specialists as well as access to support groups, and array of educational programs.

Make an Appointment With a Lung Cancer Expert

To learn more about lung cancer treatment at MD Anderson Cancer Center at Cooper or to schedule an appointment with one of our lung cancer specialists, please call 855.MDA.COOPER (855.632.2667) or request an appointment form using our online form.