Staging of Lung Cancer & Treatment Decisions

Staging is a way of describing a cancer, where it is located, if or where it has spread and whether it is affecting the functions of other organs in the body. Diagnostic tests are used to determine the cancer’s stage, therefore staging may not be complete until all of the tests are finished.

Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis (chance of recovery). In general, a lower number stage of lung cancer is associated with a better outcome. However, no doctor can predict how long a patient will live with lung cancer based only on the stage of disease because lung cancer is different in each person and tumors respond to treatment differently.

Staging for non-small-cell lung cancer: uses I through IV, with I being the earliest stage and IV being the latest.

Evaluation of the tumor, lymph nodes, and metastases are included in the overall stage.

Stage I
The earliest stage of lung cancer. The tumor is found only in one lung and has not spread to any lymph nodes.

Stage II
Stage II lung cancer is divided into two substages: stage IIA and IIB.
Stage IIA is a slightly larger tumor that has not spread to the nearby lymph nodes or a small tumor that has spread to the nearby lymph nodes.
Stage IIB is a slightly larger tumor that has spread to the lymph nodes or a larger tumor that may or may not have invaded nearby structures in the lung but has not spread to lymph nodes.

Stage III
Stage III lung cancers are divided into two substages: stage IIIA and IIIB.
Stage IIIa: The tumor has spread to the lymph nodes outside of the lung, to those the tracheal area, including the chest wall and diaphragm on the same side as the cancer started.
Stage IIIb: The tumor has spread to the lymph nodes on the opposite lung or in the neck.

Stage IV
The tumor has spread to other parts of the lungs or distantly throughout the body.
Staging of small cell lung cancer: Small cell lung cancer is classified as either limited stage or extensive stage.

  • Limited stage: the tumor is found in one lung and in nearby lymph nodes.
  • Extensive: the tumor has spread beyond one lung or to other organs.

Making treatment decisions

After the cancer is found and staged, your doctor will talk to you about treatment choices. Give yourself time to take in what you have learned. The most important things to think about include the stage and type of cancer, your overall health, the likely side effects of the treatment and the chance of curing the cancer or helping you live longer. Age alone should not keep you from having treatment. Older people can benefit from treatment as much as younger people, as long as their general health is good.

The main treatment options for people with Non-Small Cell Lung Cancer (NSCLC) may include:

  • Surgery
  • Radiation therapy
  • Other local treatments
  • Chemotherapy
  • Targeted therapy

In many cases, more than one of these treatments may be used.

Surgery is rarely a treatment option for small-cell lung cancer, however, small-cell lung cancer responds well to chemotherapy and radiation therapy.

A multidisciplinary team of physician specialists will discuss your treatment options and develop a plan of care for you based on the stage of your cancer.


These doctors may include:

  • A thoracic surgeon: a doctor who treats diseases of the lungs and chest with surgery.
  • A radiation oncologist: a doctor who treats cancer with radiation therapy.
  • A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy.
  • A pulmonologist: a doctor who specializes in medical treatment of diseases of the lungs.

Many other specialists may be involved in your care as well, including patient navigators, nurses, respiratory therapists, social workers and other health professionals.


For more information about the Thoracic Surgery & Lung Center, please call (561) 263-4400.