What Is Staging of Lung Cancer?

Video Transcript

"Hi. I'm Dr. Kenneth Fink. I'm a medical oncologist at Zimmer Cancer Center, New Hanover Regional Medical Center in Wilmington, North Carolina. Staging of lung cancer is an important aspect of lung cancer. It helps us doctors know how to approach the patient. It tells us a lot about the survival of a patient. And we like to tell patients what stage their in because that helps them know more about what to expect with their treatment outcome. A lot of education is needed when we talk about the staging because there are quite a few specifics to it. The staging system we use is called the TNM system. It stands for Tumor Node Metastasis. So the tumor refers to the primary cancer. Where it started. Which is within the lung. So we talk about a T stage. We use a 1-4 designation. If the tumor is small, less than 3 centimeters we call that T-1. If the tumor enlarges and becomes more than three centimeters we call that T-2. If the tumor spreads a little bit more aggressively and is starting to invade some other tissues we call that either T-3 or T-4. The end stage is also quite important. Lung cancers have a tendency to get into the lymphatic system and implant within the lymph nodes which is the drainage system of the body, including the lungs. If it has spread to the lymph nodes, and we can tell this by doing a cat scan or other imaging tests, we'll tell the patient that their lymph nodes are involving either the local lymph nodes called N-1 or the more central lymph nodes called the mediastinal nodes which we designate N-2. And then metastasis, either you have metastasis or you don't so we say M-0 for none and M-1for having metastasis. So between the T and the N we can tell if a person has either stage 1, 2 or 3 disease. If the tumor's quite small we'll say they have a T-1 let's say N-0 disease. That would be stage 1. If their tumor's a bit bigger let's say a T-3 with N-1 nodes we might call that stage 2. If the tumor gets a big bigger and is invading or the lymph nodes, the central lymph nodes are involved, which we call N-2 disease, we would call that stage 3. And then once a patient has been found to have cancer outside of the lung or outside of the local lymph nodes of the lung we would call that stage 4 disease. So the staging system of lung cancer is important. It's the way we collect our statistics on cancer and it's what we use to help decide what kind of treatment to give patients."