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Although lung cancer is often used as an umbrella term, there are primarily three different types of lung cancers which are Non Small Cell, Small cell Cancer and Metastatic cancers. Together, they cause more cancer related deaths than any other cancer.
Mortality rates and survival of Lung Cancer patients depend on the stage of the disease, the earlier the stage the better the survival. Therefore, staging lung cancer is crucial to the diagnosis and treatment of the patient. Staging determines the degree of spread of lung cancer and also helps in determining the next course of action, especially for those in advanced stages of lung cancer.
This article will explore everything that you possibly need to know about the stages of lung cancer and how they determine the chances of survival of the patients.
What is the Significance of Staging Lung Cancer?
Staging the cancer is an essential part of the diagnosis, irrespective of the type of cancer one is suffering from.
Once your oncologists confirm the type of cancer you are suffering from, the next step is to stage how far the cancer has spread in the body to determine:
- What the next steps in the treatment would be
- The survival statistics for the patient battling the deadly disease
Lung cancer staging helps doctors determine the general outlook on the patient’s recovery while they are undergoing treatment. An accurate lung cancer staging can also give the doctor a better look into the prognosis depending on how the patient is reacting to the lung cancer treatment in india.
What is the TNM Classification in Lung Cancer Staging?
The TNM classification is a common terminology that’s prevalent in every type of cancer diagnosis. The stage of lung cancer is determined with this classification technique.
T – Tumor size and location
N – Involvement of the regional lymph node
M – Metastasis status of the cancer cells
Depending on these three factors, the doctors can analyze the tissue samples of the patient along with reports from imaging tests to better determine the stage of lung cancer the patient is in.
What are the Types of Lung Cancer?
In order to understand the “lung cancer stages of death”, one needs to familiarize themselves with the different types of blood cancer.
There are primarily two, as we mentioned before.
1. Non-Small Cell Lung Cancer (NSCLC)
It accounts for 80-85% of the lung cancer diagnosis. It is further categorized into more types –
- Squamous cell lung carcinoma
- Adenocarcinomas
- Adenosquamous carcinoma
- Large cell carcinoma
- Other (Sarcomatoid, Carcinoid tumors and other unclassified carcinomas)
NSCLC staging includes five stages from Stage 0 to Stage IV. Stage 0 and Stage I and II are considered the early stages while Stage III and IV are often considered the “advanced” stages of lung cancer.
2. Small Cell Lung Cancer (SCLC)
Accounting for around 15-20% of the total lung cancer diagnosis, SCLC is a rarer type of lung cancer. It includes two forms of staging – Limited and Extensive.
What are the Different Stages of Lung Cancer?
Lung Cancer Staging is very crucial in determining prognosis and planning treatment for patients with NSLC (Non-Small Cell Lung Cancer.
Stages of NSCLC:
As we mentioned above, NSCLC has five distinct stages in its spread and progression. These include Stages 0 to Stage IV.
Stage 0 or Occult Stage
Grouping: TX, N0, M0
In the occult stage, although the tests such as bronchial washings / sputum cytology signs of malignancy, the actual tumor isn’t traceable by imaging tests such as CT Scan. This means that the primary tumor is hidden and localized and hasn’t spread to the nearby lymph nodes or other parts of the body.
In Stage 0, the tumor is present in the superficial layers of the cells lining the air pathways supplying in and out of the lungs. However, the tumor has yet to infiltrate deeper into the lung tissues.
Stage I
Stage I of NSCLC further has two major sub-groups – IA and IB.
IA
Under IA, you have three potential sub-stages: IA1, IA2, and IA3.
IA1
Grouping: T1, N0, M0
This includes a type of Lung Cancer featuring a tumor measuring up to 3 cm in size. It hasn’t spread to the lymph nodes or other organs in the body yet.
IA2
Grouping: T1a/T1b, N0, M0
T1<1cm
T1B>1-2cm
T1C<2-3 cm
There can be two scenarios related to the tumor size in this stage. It can either measure around and under 1 cm or over 1 cm. In the former stage with less than 1 cm in size, there are chances that cancer has breached the membranes around the lungs but has yet to infect the bronchi and its primary branches. In the latter (T1b), the tumor hasn’t reached the membrane or the bronchi yet.T1ab differential in mainly on size.
IA3
Grouping: T1c, N0, M0
The tumor measures over 2cm but not more than 3 cm. Also, like IA2, it has yet to affect the membrane and the associated branches supplying the bronchi.
IB
Grouping: T2a, N0, M0
Please follow TNM Staging for Lung Cancer AJCC 8th Edition
The tumor in this stage might either be over 3 cm or less than 4 cm and has likely reached the branch of the main bronchus. Also, there are chances that the tumor has already infested itself into the visceral pleura, which are the membranes surrounding the lungs. The tumor could also impose restrictions on the airways – partially.
Stage II
Stage II is further grouped into two more stages – IIA and IIB.
IIA
Grouping: T2b, N0, M0
The tumor measures over 4 cm and less than 5 cm and has infested into the main bronchus and the membranes supplying the lung. Since the tumor is effectively larger in size, it can impose partial blockages in the airways.
IIB
Grouping: T2a/T2b, N1, M0
The other type of Stage II lung cancer that deserves special mention is IIB. Under this, the tumor measures over 3 cm and less than 5 cm. Similar to IIA, it has grown into the main bronchus and the membrane surrounding the lungs. This is also the stage where the tumor has infiltrated the surrounding lymph nodes.
Stage III
Stage III of Lung Cancer is further categorized into IIIA, IIIB, and IIIC.
IIIA
Grouping: T2a/T2b, N2, M0
The tumor measures over 3 cm but less than 5 cm across. Not only has it grown into the main bronchus, but it has also likely affected the membranes supplying the lungs. There are chances that cancer has already spread to the lymph nodes present around the carina or the mediastinum, outside the Lung but in the same pleural cavity.
IIIB
Grouping: T2a/T2b, N3, M0
Under this stage of lung cancer, the tumor measures between 3-5 cm across and has already grown into the main bronchus but not into the carina. It has infiltrated into the membrane around the lungs and is inhibiting the airways. As for the spread, the cancer cells have infiltrated into the lymph nodes in the collar bones or inside the opposite/contraletral mediastinum in the lungs.
IIIC
Grouping: T3, N3, M0
The lung cancer tumor measures between 5-7 cm and has grown into the chest wall, including the inner lining of the chest wall. It is also infiltrating the function of the phrenic nerve, and the associated membrane around the lungs. Cancer has already spread to the lymph nodes or the hilar in the lungs.
Stage IV
The last and one of the final stages of lung cancer before death is this one and it can be further categorized into IVA and IVB.
IVA
Grouping: Any T, Any N, M1a
Since it’s the last and the most advanced stage, there is no specificity to the size of the tumor. Also, it has likely infiltrated into the nearby structure, including the adjoining lung and the lymph nodes supplying it. The cancerous cells might have also infiltrated the fluid around the lungs and heart. Irrespective of the size of the tumour, if the tumor cells have involved the pleural surface or pericardium than it is called Metastatic disease and classified as M1a / Stage IV.
IVB
Grouping: Any T, Any N, M1c
The last stage of NSCLC is Stage IV, IVB of lung cancer. Besides the lack of specificity of the size of the tumor, it has also likely metastasized to the major organs in the body, including the brain, liver, bones, etc.
Stages of SCLC:
Unlike Non-small Cell Lung Cancer, SCLC doesn’t have a lot of prominent staging. In fact, there are only two stages in the equation:
Limited stage
This is the earlier stage of lung cancer and typically involves a situation where cancer or the tumor is only limited to one lung and hasn’t spread to the lymph nodes yet.
Extensive stage
This is the advanced stage of lung cancer, which involves the rigorous spread of the lung cancer outside of the lung in which the tumor originated. It is also the stage that involves maximum metastasis.
Conclusion
Understanding the stages of lung cancer is crucial to a patient’s diagnosis and treatment. Accurate staging significantly gives the doctor and the patient a clear understanding of their prognosis, chances of survival, and also their life expectancy with such a deadly disease.
Earlier diagnosis is essential to an effective treatment plan for lung cancer patients. For more details and queries, visit https://drarvindkumar.com/contact-us.php.
FAQs
Is Stage 4 lung cancer treatable?
Stage 4 Lung Cancer can not be cured as the cancer has spread beyond its organ of origin and is no longer localized. However, advances in chemotherapy, radiation therapy along with targeted therapy and Immunotherapy have allowed us to control the growth of cancer cells and provide symptomatic and relief.
Is lung cancer curable if detected at an earlier stage?
Early stages of lung cancer typically involve stage 0, stage I, and stage II. These are the more manageable stages, meaning that the chances of treatment to be in remission is comparably higher in the patient. However, life
Can you live with stage 4 lung cancer?
The prognosis for patients with Stage 4 lung cancer isn’t very favorable. In fact, studies report that around 18% of patients live for 12+ months following the diagnosis.
