Lung cancer is one of the most common and serious types of cancer in the UK. In this blog post, we will discuss the different stages of lung cancer, what they mean, and the typical treatment options available in the UK for each stage.
Introduction
Lung cancer is the third most common cancer in the UK, accounting for 13% of all new cancer cases. Over 47,000 people are diagnosed with lung cancer every year in the UK. One of the first things patients want to know is what stage their lung cancer is in. Understanding the stage of lung cancer helps doctors determine the best treatment options and provides patients an indication of prognosis.
What Do The Stages Mean? Lung cancer staging refers to how far the cancer has spread within and outside the lungs. Staging for lung cancer can be complex, but in general earlier stages indicate less progression while higher numbers represent more advanced disease.
Stage 1 Lung Cancer
Stage 1 means the lung cancer is small and has not spread to any lymph nodes or other organs. This is early stage lung cancer where surgical removal of the tumor may lead to a cure in many cases.
Stage 1 is divided into two substages:
1A lung cancer: The cancer is 3 cm or smaller and has not spread to lymph nodes or distant sites.
Stage 1B lung cancer: The cancer is larger than 3 cm but has not yet spread to lymph nodes or distant organs.
Treatment: For many stage 1 lung cancers, doctors recommend surgery to remove the tumor. If surgery is not an option, physicians may use radiation therapy instead. Oncologists typically do not need chemotherapy for stage 1.
Stage 2 Lung
Cancer Stage 2 lung cancer means the tumor is larger than stage 1 or cancer cells have spread to nearby lymph nodes.
As with stage 1, stage 2 has two substages:
Stage 2A: The cancer has spread to lymph nodes around the lung or in the lung area but not distant nodes. OR, the tumor is larger than 5 cm wide.
Stage 2B: The cancer has spread to distant lymph nodes around the carina (inside chest) or aorta (near spine).
Treatment: For stage 2 lung cancer, doctors typically treat patients with surgery to remove sections of infected lung tissue plus chemotherapy or radiation therapy. This combined approach reduces risk of recurrence.
Stage 3 Lung Cancer
Stage 3 indicates more advanced lung cancer where the tumour is large or growing into nearby tissues, and cancer has spread to lymph nodes further away from the lungs.
There are two substages of stage 3:
Stage 3A: Cancer is found in lymph nodes between both lungs and behind the breastbone OR has invaded deeper chest structures but not critical tissues like the heart or esophagus.
Stage 3B: Cancer has invaded critical chest structures (heart, major blood vessels, trachea, recurrent laryngeal nerve) or spread widely throughout the mediastinal lymph nodes.
Treatment: Standard treatment for stage 3 is radiation plus chemotherapy (chemoradiation). Sometimes surgery is done after chemoradiation to remove any remaining tumor.
Stage 4 Lung Cancer
Stage 4 is the most advanced stage of lung cancer, where cancer has metastasized (spread) to distant lymph nodes and organs. Common sites of metastases include the liver, bones, adrenal glands and brain.
There is no stage 4 subdivision due to the severity of distant metastatic lung cancer.
Treatment: Stage 4 lung cancer is very difficult to cure. The goals of treatment are typically to slow the progression, ease symptoms, and prolong life. This includes chemotherapy and targeted drug therapy tailored to the individual.
Conclusion
Staging provides valuable information for lung cancer prognosis and guides the best options for treatment. While early diagnosis at stage 1 or 2 allows for better outcomes, there are still hope and treatment options available even at later stages. Significant advances in chemotherapy, radiation therapy, surgery and targeted drugs now help many patients with lung cancer live longer with improved quality of life. Anyone diagnosed with lung cancer in the UK can work closely with their medical team to determine optimal treatment approaches based on the specific stage and nature of their disease.