Stages

What is TNM staging?

Doctors use a system called TNM staging to describe lung cancer. This can help other health professionals to understand the level of growth of the cancer and how far it has spread.

The numbers next to each letter show the scale of cancer growth. Zero indicates ‘none’, while a higher number in each range means the cancer is more advanced. 

• T stands for tumour: This number points to how big the tumour is and how deep it has grown. (T0 to T4)
• N stands for nodes: This number describes how far cancer has spread to nearby lymph nodes. (N0 to N3)
• M stands for metastasis: This number indicates if cancer has spread to other parts of the body. (M0 to M1)

After the clinical team has determined what kind of lung cancer you have, they will use the results of the tests you received during diagnosis to determine the stage. Knowing the stage of your lung cancer will help determine what treatment is most appropriate for you. Speak to your specialist if you need more details about staging.

Overall stages for lung cancer

• Stage 1: Cancer is only located in the lung.
• Stage 2: Cancer has spread to nearby lymph nodes or the lining of the lung.
• Stage 3: Cancer has spread to more lymph nodes in the chest or the lining around the heart. It might have also spread to the lower neck.
• Stage 4: Cancer has spread to the other lung, other parts of the body (like bones, liver, or brain), or to the fluid around the heart or lung.

Small cell lung cancer (SCLC) staging

Small cell lung cancer can be staged with the TNM system, or sometimes, it can be staged using a different system in which the tumour is classified as either limited or extensive: 

• Limited disease: The cancer is only located in one lung, with or without spreading to the lymph nodes in the area between the lungs (mediastinum)
• Extensive disease: The cancer has spread to tissue outside the original affected lung, such as the opposite lung or other organs.

Staging can be complex. Don’t be afraid to ask your doctor to explain your specific stage in a way that you understand. By understanding more about your lung cancer, you can find advice, options and treatments that are relevant to you.