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Why Stages Are Important

They tell you how big your tumor is, how far the cancer has spread, and where in your body it's located. Your lung cancer stage is written in numbers. Your doctor uses it to find the right treatment for you. In general, the lower the stage, the easier it is to treat the disease.

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Tests to Figure Out Your Stage

You'll get exams such as:

  • MRI (magnetic resonance imaging). It uses magnets and radio waves to see structures inside you.
  • CT (computed tomography). A powerful X-ray that makes detailed pictures inside your body.
  • PET (positron emission tomography). A scan that spots cancer cells in your body after a doctor injects a radioactive dye in your veins.
  • Biopsy. Your doctor removes cells and checks for signs of cancer.
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Stages of Small-Cell Lung Cancer

If you have this type of lung cancer, your doctor may tell you that you're in one of these two stages:

  • Limited stage. Your cancer is on one side of your chest. You can treat it with radiation.
  • Extensive stage. The cancer has spread to other areas, like the other lung, bones, or your brain. Chemotherapy is a good treatment option, because it can kill cancer cells all over your body.
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What Is TNM Staging?

You may hear your doctor use three letters -- T, N, and M -- to describe how your lung cancer has grown and spread.

  • T. Your tumor size, and whether it has grown outside of your lung.
  • N. Your cancer has moved to the lymph nodes -- small, bean-shaped glands that carry fluid and other substances around your body.
  • M. Your cancer has spread (metastasized) outside your lungs or to other organs.
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Giving It a Number and Letter

Your doctor uses your TNM stage to assign your cancer a number and a letter. Cancers are grouped by Roman numerals (I, II, III, and IV) and the letters A and B, based on the size of the tumor and where it has spread. Lower-stage cancers are usually easier to remove with surgery.

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Occult Stage

Occult means "hidden." If your doctor says you're in this stage, your cancer can't be seen on X-rays or other imaging tests. But they may have found abnormal cells in your phlegm or other fluids from your lungs. You'll have regular checkups and imaging tests to monitor your condition.

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Stage 0

If you're in this stage, you may hear your doctor say your cancer is "in situ," which means "in place." In stage 0, cancer cells are only found in the lining of  the air passages. They haven't spread to lymph nodes or to other parts of your body. Surgery may be enough to remove the cancer at this point.

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Stage IA

At this point, your tumor is no bigger than 3 centimeters (1 inch) across -- smaller than a quarter. It's only in your lungs. It hasn't reached the lymph nodes or spread to other parts of your body. Your doctor may suggest surgery to treat it. You might also need chemotherapy or radiation to kill any cancer cells the surgery doesn't get.

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Stage IB

Tumors in this stage measure 3-4 centimeters (1 to 1.5 inches) across. The cancer hasn't spread to any lymph nodes, though it may have moved to the layer of tissue that covers your lung. The cancer might also have spread to the large airway that connects your windpipe to your lung.

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Stage IIA

The tumor is now 4-5 centimeters wide (1 to 2 inches). It may have grown into the airway that connects your windpipe to your lungs or to the tissue that surrounds the lungs. Your cancer might have moved to lymph nodes on the same side of the lung as the tumor, but hasn't spread outside your lung. You may need surgery and chemotherapy -- or radiation after that -- to kill any cancer cells that are left behind.

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Stage IIB

The tumor may measure up to 7 centimeters (3 inches). The cancer may have spread to the windpipe that connects your airway to your lung, the tissue that covers your lung, or to your chest wall or your breathing muscle (called the diaphragm). It may have also moved to lymph nodes on the same side of the chest as the lung that has cancer, or to the lining around your heart.

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Stage IIIA

The cancer can be any size now. It might have spread to your chest wall, diaphragm, heart, windpipe, esophagus, chest bone, backbone or membrane that surrounds the lung. The cancer could also be in lymph nodes on the same side of the chest as the main tumor. At this point, the tumor might be big enough to make the whole lung collapse. By stage III, surgery alone can't treat the tumor. You'll need chemotherapy and radiation, too.

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The cancer may have spread to lymph nodes above your collarbone or on the opposite side of the chest as the tumor. It might have reached your heart or its blood vessels, as well as your esophagus, windpipe, a nerve that controls the voice box, chest bone, or backbone. 

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Stage IV

The cancer has likely spread to the other lung. It may also have moved to lymph nodes, and from there to organs like the brain, liver, kidney, or bone. Cancer can also be in the fluid around your lungs or heart. Stage IV cancer is harder to cure, but it can still be treated. Chemotherapy, radiation, immunotherapy, and targeted therapy can help you live longer and relieve your symptoms.

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Sources | Medically Reviewed on 11/02/2019 Reviewed by Laura J. Martin, MD on November 02, 2019


American Society of Clinical Oncology: "Lung Cancer-Small Cell: Stages."

National Cancer Institute: "Non-Small Cell Lung Cancer Treatment (PDQ)--Patient Version."

American Cancer Society: "Small Cell Lung Cancer Stages," "Treatment choices for non-small cell lung cancer, by stage."

Goldstraw P, Chansky K, Crowley J, et al. 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. J Thorac Oncol 2016; 11:39

Reviewed by Laura J. Martin, MD on November 02, 2019

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.