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14th May 2021

Why are lung cancer stages important?

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Understanding the stage of lung cancer is an essential part of the lung cancer diagnosis journey. It gives doctors all the information they will need to decide what kind of treatment or surgery options will be available.

The stage of lung cancer determines the size of the lung cancer tumour, whether the lung cancer has spread to the lymph nodes, and if the lung cancer has spread to other parts of the body.

The lung scans, biopsies, and tests that a person goes through during diagnosis give doctors the information about the stage of the lung cancer. However, in some cases like Ruthra’s – the stage of lung cancer is determined after surgery.

It was only actually confirmed as lung cancer after my surgery. I’d had further tests before my surgery, but they were inconclusive, so I ended up going for surgery because of the location of where the mass was. It was after surgery that the doctors discovered stage 1 lung cancer

Ruthra Coventry – who underwent curative surgery aged 38

Lung cancer staging systems

A common way for doctors to establish the stage of non-small cell lung cancer is by using the TNM system. Which stands for Tumour, Node, Metastasis.

Doctors give each component a number, and the lower the numbers, the smaller or more contained the cancer is. (Eg, T1 N0 M0 would mean a small lung cancer that hasn’t spread)

Another way to stage lung cancer is by the number staging system. This separates lung cancers into four different stages.

  • – Stage 1 – the lung cancer is small and localised (the cancer hasn’t spread)
  • – Stages 2 and 3 – the lung cancer is bigger and may have spread into surrounding lymph nodes and tissues.
  • – Stage 4 – the lung cancer has spread to other parts of the body (metastasised)

Doctors use a two-stage classification for small cell lung cancer.

  • Limited stage – this describes lung cancer that is contained in one lung and some surrounding lymph nodes.
  • Extensive stage – the lung cancer has spread to other areas in the body.

Treatment variations

Everyone is different, and so is each case of lung cancer. When lung cancer treatment plans are being put together for an individual, their previous medical history will be considered, so that means two people who are living with the same stage lung cancer may be cared for and treated in different ways.

The aim of treatment will vary depending on the stage of lung cancer. Doctors may focus on limiting the lung cancer growth or reducing the size of the tumour. This is done using treatments such as radiotherapy, chemotherapy, or newer treatments such as immunotherapy and targeted therapies.

Treatments for lung cancer have developed immensely over recent years, and if lung cancer is caught at an early stage like Andy’s was, curative intent treatment and surgery could be available.

When I was diagnosed with lung cancer my heart sank. I just thought lung cancer was one of the worst types of cancers and that there was no way through it. The doctor explained I had stage 2 non-small cell lung cancer and that there was curative intent treatment available

Andy Libby had a lobectomy after his lung cancer was found early

Late-stage lung cancer

The face of stage 4 lung cancer has changed a lot in recent years. Survival rates have increased, most notably, 10-year survival has now doubled.

Sadly, late-stage lung cancer is usually incurable, but advances in treatments which slow down the spread of lung cancer means that it can be treatable. These developments in treating late-stage lung cancer mean that symptoms can be managed, and people can live well with the disease.

I was told my lung cancer was inoperable and incurable. I went numb. But then they said the word ‘treatable’. My lung cancer was treatable, so I focused on that.

Anne Libby – who is living with stage 4 lung cancer

Anne was diagnosed with stage 4 lung cancer after experiencing fatigue, wheezing and weight loss. She has been treated with a combination chemotherapy and immunotherapy and is now being treated with maintenance chemotherapy.

Depending on your treatment, you will attend regular check-up scans to see if the treatment is working and your tumours are reduced, or if they remain stable.

I love hearing that word. Stable. When you get your latest scan results, and they say the word ‘Stable’ it’s a huge relief because you can get on with living for another three months before the next scan.

Anne is a keen runner and has been able to keep active throughout her treatments, completing several our virtual runs.

A lung cancer diagnosis can be a huge shock to the system. You may experience a variety of emotions including numbness, anger, helplessness, shock and fear. It is important to remember that it is normal to experience a range of emotions after receiving a diagnosis. Our Managing your Lung Cancer Diagnosis booklet provides support and advice about how to deal with a lung cancer diagnosis.