Before explaining lung cancer stages, we should note that there are two types of lung cancer; and these two types have different lung cancer stages. Firstly, we will talk about small cell lung cancer stages and then, n0n-small cell lung cancer stages are our focus today. After those explanations, we will talk about basic symptoms, risk factors, and possible treatments. Stages of lung cancer and the size of the tumor are the most important determinants of the treatment. Therefore, lung cancer stages play a vital role to decide what kind of treatment these patients will have. Lung Cancer Stages are investigated regarding the types of cancer. Non-small Cell Lung Cancer has four stages; the researchers have put them in an order from one to four regarding its possible danger. Stage one means the weakest tumor while stage four is the biggest one. Small cell lung cancer has two stages regarding how much it spread into the body, which is limited or common.
Table of Contents
Research has shown that nearly 15-20% percent of lung cancer patients have small cell cancer cells.
These small cells are capable of dividing in a fast way; this situation is actually what makes them dangerous.
It can spread up to other structures in the body because the tumor is able to get bigger rapidly; this situation is called “metastasis”. If the cancer cells metastases; the tumor is seen in other organs or structures in the body.
The main reason for lung cancer is smoking; tobacco products are the triggers for this disease.
Chemotherapy combined with radiotherapy is the major treatment given to the patients.
We said that small cell lung cancer accounts for nearly 15% of the cases; it means that a big majority of the cases is non-small cell; as you guess from the name of disease, it has big cancer cells; but the experts note that this type of lung cancer is not as aggressive as non-small cell lung cancer; it doesn’t spread to the rest of the body in a fast way.
The squamous: it is originally called squamous cell carcinoma. It is seen in the large airways of smoking people.
The glandular: it is the second type of non-small cell lung cancer. It exists in the small airways in contrast to the squamous type.
It should be noted that these cancer cells may live in the body before the doctors detect them. If it is small and doesn’t spread to other parts of the body, an operation can help the patients. The surgeons can take the tumor out or can remove a part of the lung to clean the organ.
The primary reason for lung cancer is surely smoking tobacco products; it is even the main reason for more than 75% of lung cancer cases today. However, not only smoking tobacco products but also living around those people who smokers are enough to have this disease because being a passive smoker doesn’t matter; you breathe the same air.
Some chemicals and particles are also seen as a reason or triggers for lung cancer cases such as chromium, asbestos, arsenic, asbestos. They all enhance the risk. You should keep your safe and stay away from these substances.
Research and cases have let us see that lung cancer is sneaky and do not show any symptoms until it becomes relatively dangerous. When people understand that they have lung cancer after the diagnosis, it is generally long after the cancer cells have already metastasized, which makes the treatment much harder. However, there are some signals which may indicate that you have these cancerous cells in your body;
Permanent coughs (coughing endlessly, it bothers you a lot)
Pain the chest
Pain the bones
Loss of weight
Loss of appetite
The experts advise people to have a medical check-up each year to diagnose these type of dangerous diseases at early stages.
Non-small Cell Lung Cancer (NSCLC)
It is responsible for %80 of all lung cancer cases in the USA, which means it is much more common to have non-small cell lung cancer for people.
Small Cell Lung Cancer
We evaluate small cell lung cancer in two stages; thorax (chest) is limited and common.
Cancer is limited in the chest cavity, that is, in the early stage, the tumor is present in the lymph glands and lungs.
In the widespread stage, the tumor has spread to other organs as well as to other lungs.
Small-cell lung cancer, in particular, is prone to brain metastases. For this reason, further investigation is necessary.
Lung Cancer Stages Life Expectancy
Non-Small Cell Lung Cancer patients 5 years survival is %40 to %50 in stage 1; %30 in stage 2; stage 3a %14; stage 3b %5 and finally stage 4 is %1.
However, you should keep it in your mind that these statistics are from 2015 and there are recently developed treatments; those people can live much longer than 5 years.
Non-small Cell Lung Cancer Stages
The experts categorize the disease into four stages; they take the quantity and size of the tumor into the consideration and decide the stage of non-small cell cancer. There are some subtypes of the disease; we will explain them in detail.
Lung Cancer Stage 0
In this stage, it is originally called “carcinoma in situ or adenocarcinoma situ”. The cells exist in the respiratory tract or alveolar sacs of the patient’s lung.
Lung Cancer Stage 1
It has 2 subtypes.
The size of the tumor is not more than 3 centimeters and it is found in the lung. Stage 1A has 3 subtypes. These are 1A1, 1A2 and 1A3.
Firstly, 1A1; the size of the tumor is not longer than 1 centimeter.
Secondly, 1A2; it is around 1 or 2 centimeters.
Thirdly, 1A3; the extent of the tumor is bigger than 2 centimeters but it is smaller than 3 centimeters.
Size of the tumor in this stage is between 3 and 4 centimeters. The tumor exists in the main respiratory tract but hasn’t reached the trachea region. It also exists in the visceral pleura. (It is internal membrane around the lungs). This has resulted in the breakdown of a lung or makes a bronchus useless and also resulted in obstructive pneumonitis, which is explained as lung tissue’s inflammation in daily language; it may include a part of the lung or the entire lung.
Lung Cancer Stage 2
It has 2 subtypes.
The lung tumor is greater than 4 cm but not more than 5 cm or it has:
The extent of the cancer cell is between 4 and 5 centimeters or it has reached the main respiratory tract but hasn’t reached the trachea region. It has resulted in the breakdown of a lung or makes a bronchus useless and also resulted in obstructive pneumonitis, which is explained as lung tissue’s inflammation in daily language. This may include a part of the lung or the entire lung. It has already located in the internal membrane which neighbors the lungs.
The extent of the tumor is greater than 5 centimeters and it already has covered the lymph nodes around the bronchi or. In this stage, there is generally more than one tumor exists in the lung. One or several of the following may happen in the patients’ body;
The size of the cancer cells is between 5 and 7 centimeters. (Not less or more than that). The tumor has reached outer membrane which is around the lung, the chest wall, the main nerve going to diaphragm, phrenic nerve, outer membrane which is around the heart or the parietal pleura.
Lung Cancer Stage 3
Stage 3 has 2 subtypes.
A tumor in stage 3A is not greater than 5 centimeters; but, it invaded lymph nodes which are located in the area in which trachea divides strains of left and right or the trachea located next to the lymph nodes on the same side of the body. By the way, there is generally one more tumor in the lung in this stage.
The other possibility is the size of the tumor is greater than 5 cm; in this scenario, there are 2 possible situations. Firstly, the cancer cells have spread to lymph nodes around the bronchi. Secondly, the cells have metastasized some of the structures or organs in our bodies such as the main nerve, the mediastinum, the heart or large blood vessels, the trachea region, the diaphragm, esophagus or a bone of the vertebra.
The extent of the tumor is greater than 5 centimeters and the cancer cells have invaded to lymph nodes on the trachea’s opposite side or lymph nodes which are located in the lower neck. At this stage of cancer, there is more than one tumor in the lung. The cancer cells may have spread to lymph nodes around the trachea or the area in which trachea divides strains of left and right.
Lung Cancer Stage 4
Lung cancer stage 4 has 2 subtypes. At this stage of lung cancer, the cancer cells have invaded the other structures, parts or organs of the body. If it has invaded the other organs in the body, it is called distant metastases.
One or several of the following statements happens in the body; the cancer cells may have spread to the pleura or pericardium; or it has invaded the other lung; the case of effusion starts to be seen in pleura or pericardium, which means fluid locates there. Because cancer has metastasized, one more tumor exists in other organs besides the lung or chest.
It is the most dangerous stage of lung cancer. The difference between the stage 4A and 4B is that there is not one more tumor in other organs; two or more tumors invades the other organs, structures of the body.
Small Cell Lung Cancer Stages
There are 2 stages of small cell cancer; the limited one and extensive one. If the stage of small cell lung cancer is limited; it means that the cancer cells exist in the thorax; but, if it is the extensive stage, we understand that the cancer cells have invaded the other structures and parts except for the thorax.
For this type of cancer, doctors do not advise patients about surgical operations; they do not use them very often. Stage of the cancer is not as much important as it is in non-small cell cancer; doctors generally choose chemotherapy to give treatment to the patients and combine it with radiotherapy.
Lung Cancer Treatment
The lung cancer treatment relies on some aspects such as the size of the tumor, its type, patients and what they want. There are some tests which doctors use to diagnose the disease. CT Scan, X-Ray, Magnetic Imaging, blood or sputum analysis are regarded as the key techniques to diagnose the lung cancer. After diagnosis, doctors use tomography and bone scintigraphy for further investigation to understand if metastasis exists or not.
it should be noted out that there are several ways to give treatment to the patients, which are surgery, chemotherapy & radiotherapy and drug treatments. Doctors also use targeted therapies and immunotherapy to help patients recover relatively fast. The experts make a choice by evaluating the size of the tumor, it’s stage and type and the health condition of the patient. Before making a decision, the patients should know what they want, what is waiting for them after the treatments, side effects and other things related to the treatment choice.
Sources and for further understanding for you
We can follow and read some magazines or articles on current treatment ways for lung cancer. You can search them on Google Scholar.
“Systemic Therapy for Stage IV Non–Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update” Click here to read.
A new attempt to classify stages;
“The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer” Click here to read.
“Pembrolizumab for the Treatment of Non–Small-Cell Lung Cancer” written by a group of researchers. Click to go to that article.