Download About lung cancer staging - Welsh Cancer Intelligence and

Lung Cancer in Wales, a detailed analysis of population
trends of incidence and stage at diagnosis up to and including 2012
About lung cancer staging
The stage of a cancer is usually determined by X-rays, scans or histology.
Clinicians will always consider the stage of a cancer when considering
appropriate treatment.
The stage describes “the status” of the cancer at the
time of diagnosis. An international classification is used to assess this status. It
is called the TNM (currently 7th Edition).
TNM stands for:

Tumour (size and extent of invasion) - records the size of the tumour at
diagnosis

Nodes (presence/absence of tumour - records the local spread of the
tumour into the lymphatic system (also described as involvement)

Metastases (tumour spread to other organs) records whether the tumour
has metastasized, via the blood stream or lymphatic system other part of
the body (this is known as secondary or metastatic cancer)
These 3 components are then aggregated into an overall Stage 1–4 (which may
be subclassified i.e. 1A, 1B etc.).
The Stage Groupings are generally as follows:
Stage 1 - the cancer is small and localised in one area.
Stage 2 - the cancer is larger and may have grown into surrounding tissues and
there may be cancer cells in the regional lymph nodes (those lymph nodes local
to the organ in which the tumour is sited).
Stage 3 - the cancer may be larger, has directly spread to other structures, or
there is involvement of lymph nodes.
Stage 4 – the cancer has spread to another organ.
In summary, the lower the stage number recorded, the better the prognosis is.
The higher the stage of the cancer, the worst the prognosis is.
Welsh Cancer Intelligence and Surveillance Unit
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Lung Cancer in Wales, a detailed analysis of population
trends of incidence and stage at diagnosis up to and including 2012
The Lung cancer stage groupings are as follows:Stage 1A - the tumour is small (up to 3cm).
Stage 1B - the cancer is between 3 and 5cm. It may have spread into nearby
structures.
Stage 2A - the cancer is between 5 and 7cm but there are no cancer cells in
any lymph nodes.
Or it is 5cm or less and there are cancer cells in the lymph nodes close to the
affected lung. In either case it may have spread into nearby structures such as
the bronchus) or the pleura. Or the lung may have partly collapsed.
Stage 2B - the cancer is between 5 and 7cm and there are cancer cells in the
lymph nodes close to the affected lung
Or, it is larger than 7cm but there are no cancer cells in any lymph nodes
Or, it is not in any lymph nodes but has spread into one or more of the following
areas – the chest wall, diaphragm, the phrenic nerve, or the layers that cover
the outer layers of the heart
Or, it is In the bronchus close to where it divides to go into each lung
Or, it is making part of the lung collapse
Or, it is any size but there is more than one tumour in the same lobe of the lung.
Stage 3A the cancer is in the lymph nodes close to the lung and the cancer is
bigger than 7cm or there are 2 tumours
Or, is smaller and growing into one of the following areas – the chest wall, the
diaphragm, or the layers that cover the heart or the phrenic nerve
Or, the cancer is more than 7 cm and there are cancer cells in lymph nodes and
in mediastinum
Or , the cancer is any size but has grown into another major structure in your
chest, such as the heart, the trachea, the oesophagus, the nerve that goes to
the larynx, a spinal bone, or a main blood vessel There may also be cancer cells
in lymph nodes close to the affected lung,
Or, the cancer is in more than one lobe of the same lung and may have spread
into lymph nodes close to the affected lung.
Welsh Cancer Intelligence and Surveillance Unit
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Lung Cancer in Wales, a detailed analysis of population
trends of incidence and stage at diagnosis up to and including 2012
Stage 3B the cancer has spread into lymph nodes on the opposite side of the
chest from the affected lung.
Stage 4 this means that the cancer is in both lungs.
Or, has spread to another part of the body, for example, the liver or bones
Or, has caused a malignant pleural effusion) or pericardial effusion
Welsh Cancer Intelligence and Surveillance Unit
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