Lung Cancer Stages: A Simple Explanation

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J. Rob Headrick, M.D., thoracic surgeon, CHI Memorial Chest and Lung Cancer Center

If you’ve been recently diagnosed with lung cancer or know someone who has, the topic of staging has likely come up in the conversation. Correct staging is important and different for each type of cancer. What methods we use to treat lung cancer depends on where the cancer began and where it’s moved inside the body. Doctors determine staging through a history, physical and imaging studies.

Because lung cancer is complicated – and emotional – my goal is to talk with my patients and have a two-way conversation about treatment rather than give a speech about staging and treatment modalities. The easiest way to think about cancer staging is to imagine a city like Chattanooga.

If we find the cancer when it’s in the city limits of Chattanooga – or confined to one specific location – this is stage 1. The cancer is within the boundaries of one area, and it’s fairly straightforward to remove the cancer completely with surgery.

Stage 2 is similar to Stage 1 in terms of where the cancer has moved. The cancer is still within one main area like the city center but has begun to move to one or more of the surrounding communities like East Ridge or Signal Mountain. Within Stage 2, the cancer has moved to these areas through well-defined pathways (no back roads were taken). Again, surgery is the first approach to treatment.

Things get a little more complicated at Stage 3. The cancer cells that were originally in Chattanooga have moved farther down the road – to Dalton or Nashville or Knoxville. But in this stage, the cancer hasn’t necessarily stayed on the interstates. In fact, it’s likely used many backroads, with twists and turns we can’t predict and are harder to contain. It’s in Stage 3 that the benefits of surgery begin to fall off, and we think about chemotherapy or radiation therapy as our first line of treatment. Sometimes surgery is used later after these methods have done their work.

In Stage 4 lung cancer, what started in Chattanooga has now travelled a long distance – to Chicago, or Los Angeles or New York. Because of the multitude of ways to travel and the miles in between each location, cancer that has spread this far is much harder to treat. In this stage, chemotherapy is our main line of defense. 

Proper Staging Leads to Effective Treatment

Staging is a valuable tool that sets the benchmark or standard for determining your ability to fight cancer and the best treatment options. I work with each of my patients to help them understand their cancer in simple terms and find a way to fight it most effectively. What we do is personalize care.

If you’ve received a diagnosis you don’t understand, we’d like to talk with you. Call our Second Opinion Clinic at (423) 495-5864 (LUNG) to schedule an appointment.  

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Doctor Talk, CHI Memorial's blog, focuses on health and welness.