Stages of non small cell cancer

Non small cell cancer can be divided into four stages

Stage I

This means the cancer is localised. There is no cancer in any lymph nodes.

Stage 1 can be divided into 1A and 1B. Stage 1A means the tumour is small (3cm or less across). Stage 1B means the cancer is larger or that it is growing in the main airway of the lung (the main bronchus). Stage 1B includes cancers that have grown into the inner covering of the lung or caused a partial collapse of the affected lung.

Stage 2

Stage 2 is divided into stages 2A and 2B. Stage 2A means the cancer is small, but has spread to the lymph nodes closest to the affected lung.

Stage 2B can mean one of two things

• The cancer in the lung is larger than 3cm across and there is cancer in the lymph nodes nearest the affected lung or
• There is no cancer in the lymph nodes but the cancer has grown into the chest wall, the outer covering of the lung, the muscle at the bottom of the chest cavity (the diaphragm) or the outer covering of the heart.

Stage 3 is divided into stages 3A and 3B. 3A can mean one of two things. There is cancer in nodes further away from the affected lung, but still on the same side of the chest. Or there is cancer only in lymph nodes nearest to the affected lung but the cancer has also spread to either the chest wall or the covering of the lung (pleura) or the middle of the chest (mediastinum).

3B cancer means one of 4 things

• There is cancer spread to nodes on the other side of the chest or to nodes above either collarbone
• There is more than one tumour in the affected lobe of your lung
• The tumour has grown into another major structure in your chest, which could be the heart, the windpipe, the gullet (oesophagus) or a main blood vessel
• There is a fluid collection around your lung that contains cancer cells (a malignant pleural effusion)

Stage 4 means the cancer has spread to another lobe of the lung from where it started or to another part of your body, for example the liver or bones.

The scans and tests you have done should give your doctor some idea of the stage of your cancer. But it may not be possible to be completely sure until you have had an operation. In most cases however the tests described in Diagnosing Lung Cancer are enough for your doctor to tell the stage.