Lung Cancer Diagnosis

If you are worried that you have symptoms of lung cancer, make an appointment with your general practitioner. Your doctor will evaluate your medical history—including any risk factors you might be exposed to—and perform a physical examination of your symptoms to determine the possibility of cancer. Your doctor may then refer you to a specialist for additional testing. If cancer is suspected, a biopsy must be performed to confirm a cancer diagnosis.

Stages of Lung Cancer

Once you receive a positive diagnosis, your doctor will categorize your lung cancer in stages. The stage describes the progression or extent of your cancer, and will help your doctor determine which treatment is best for you. Keep in mind that staging does not necessarily indicate the likely course and outcome (prognosis) of your lung cancer. Your prognosis depends on your overall health, strength, coinciding conditions, and response to treatment.

Stages of Small Cell Lung Cancer

Small cell lung cancer is described in two stages, limited and extensive.

• Limited. Cancer is confined solely to the chest—usually just one lung, and neighboring lymph nodes. This type can be treated with chemotherapy and radiation therapy.
• Extensive. Cancer that has spread to both lungs, or beyond to other parts of the body. This type is treated with chemotherapy, clinical trials, and supportive (comfort) care.

Stages of Non-Small Cell Lung Cancer

• Occult Stage. Lung cancer cells are found in sputum or in a sample collected during a test, but there is no sign of a tumor in the lungs.

• Stage 0. Cancer cells are found only in the innermost lining of the lung and is not invasive.

• Stage IA. Cancer is found in the innermost lining of the lungs and in deeper lung tissue. The tumor is not more than 3 centimeters across and has not invaded the bronchus or the lymph nodes.
• Stage IB. Cancer has grown larger and deeper into the lung tissue. The tumor has grown through the lung into the pleura, is more than 3 centimeters in diameter, and/or has grown into the main bronchus. But the cancer has not yet invaded the lymph nodes. Surgery and sometimes chemotherapy is used to treat lung cancers in Stage IA/IB.

• Stage IIA. Cancer is less than 3 centimeters in diameter but has spread to the lymph nodes on the same side of the chest as the tumor areas.
• StageIIB. The lung cancer has not spread to the lymph nodes but has grown into the chest wall, main bronchus, pleura, diaphragm, or heart tissue. Or the cancer has spread to the lymph nodes and one of the following is true: the tumor is more than 3 centimeters in diameter, the tumor has grown into the bronchus, or the tumor has grown into the pleura.

• Stage IIIA. The tumor is any size, and the cancer has spread to the lymph nodes in the center of the chest, but on the same side as the tumor. This stage is treated with a combination of chemotherapy and radiation.
• Stage IIIB. The tumor can be any size. The lung cancer has invaded the lymph nodes on the opposite side of the chest and neck and possibly other areas such as the heart, major blood vessels, or esophagus. This stage is treated with chemotherapy and sometimes radiation.

• Stage IV. The lung cancer has spread to distant areas in the body, especially the adrenal glands, liver, bones, and brain. This stage is treated with chemotherapy, clinical trials, and supportive (or comfort) care.