Small Cell Lung Cancer: Stages

What does stage of cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

What are the stages of small cell lung cancer?

The TNM staging system

All lung cancers, including both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), can be staged using the TNM system. This system is based on 3 key pieces of information: 

• T tells how large the main tumor is and whether it has grown into nearby structures.

• N tells whether the cancer has reached nearby lymph nodes.

• M tells whether the cancer has spread (metastasized) to other organs in the body, such as your brain, bones, or liver.

Numbers or letters after T, N, and M provide more details about each of these factors.

Once the T, N , and M categories have been determined, your healthcare provider uses this information to find out the overall stage of your cancer on a 0 to 4 scale using Roman numerals (0, I, II, III, or IV). The higher the number, the more advanced the cancer is.

But the TNM system is much less useful for SCLC than for NSCLC. 

Limited vs. extensive stage

For practical purposes, doctors often prefer to divide SCLC into just 2 stages. They are based on whether you may be helped by intense treatments to try to cure the cancer, such as chemotherapy combined with radiation therapy, or if chemo alone is a better option to treat more widespread cancer. Here are the 2 stages:

• Limited. In this stage, you have cancer only in one lung. You may also have cancer in nearby lymph nodes on the same side. But all of the cancer can be reached within a single radiation field. (The radiation can be focused on 1 area and reach all the cancer in that area.)

• Extensive. If you have extensive stage cancer, the cancer has spread too far to be treated with one radiation field. It may have spread to many parts of the same lung, to the other lung, to lymph nodes on the other side of the chest, or to distant parts of the body. 

Talking with your healthcare provider

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand. Make sure to ask any questions or talk about your concerns.