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Stages of Lung Cancer

There are two main types of lung cancer, called non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Staging is a way of describing the size of the cancer, where it’s located and if and how far it has spread.

The board-certified pulmonologists at CHI Saint Joseph Health use advanced diagnostic testing to stage the cancer and develop a personalized lung cancer treatment plan, if needed.

Keep in mind that lung cancer symptoms often don’t show until the disease has progressed. That’s why we also offer low-dose CT scans to catch lung cancer in its earliest and most treatable stage. The test is fast, simple and could save your life.

Call 859.313.4673 for more information or speak with your primary care provider to schedule a low-dose screening near you.

Stages of Non-Small Cell Lung Cancer

Non-small cell lung cancer accounts for about 85% of lung cancers, and includes squamous cell carcinoma, large cell carcinoma and adenocarcinoma, the most common form of the disease among both men and women. It mainly occurs in people who smoke, or used to, though it’s also the leading type of lung cancer among non-smokers.

The main way your doctor will stage non-small lung cancer is called the TNM system:

  • Tumor (T) describes the size of the original tumor and where it’s located in your lungs or body.
  • Lymph node (N) indicates whether the cancer is present in the lymph nodes.
  • Metastasis (M) refers to whether cancer has spread to other parts of the body, usually the liver, bones or brain.

These letters are then paired with a number to determine the severity of the tumor and how much it’s spread:

  • Occult Stage: Cancer cells are found in the mucus you cough up, but the tumor can’t be seen on imaging scans or a biopsy.
  • Stage 0: The cancer is tiny and has not spread into deeper lung tissues or outside the lungs. This is called in situ disease, meaning the cancer is “in place.”
  • Stage I: The cancer is only in the lungs and has not spread to any lymph nodes.
  • Stage II: The cancer is in the lung and nearby lymph nodes.
  • Stage III: Cancer is found in the lung and in the lymph nodes in the middle of the chest, also described as locally advanced disease.
  • Stage IV: The most advanced stage of lung cancer, when the cancer has spread to both lungs, to fluid in the area around the lungs or to another part of the body, such as the liver, brain or other organs.

If non-small cell lung cancer is detected early enough, surgery is usually the first option. If the tumor is completely removed and nearby lymph nodes do not show cancer, no further treatment may be required.

For more advanced tumors, patients may need post-operative treatment with chemotherapy, radiation therapy or both. Sometimes, radiation therapy and/or chemotherapy may be recommended before surgery, to help shrink the tumor so it can be removed.

Stages of Small Cell Lung Cancer

Small cell lung cancer accounts for the remaining 15 percent of lung cancers. It is the most aggressive form of the disease, often spreading quickly to the liver, bone or brain.

The TNM system may also be used to stage small cell lung cancer, but it’s generally measured in two categories:

  • Limited stage: Cancer is found on one side of the chest, involving just one part of the lung and nearby lymph nodes.
  • Extensive stage: Cancer has spread to other areas of lung, chest and possibly the fluid around your lungs (called the pleura) or other organs like your brain.

Small cell lung cancer treatment typically does not involve surgery except in rare circumstances. Most patients are treated with a combination of chemotherapy and radiation therapy. Because small cell lung cancer often spreads to the brain, treatment may also include a low dose of radiation therapy to the brain, even if there are no tumors visible on a CT scan or MRI. This has shown to improve survival for patients with small cell lung cancer.


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