Lung Cancer Stages

What is lung cancer staging?

Lung cancer staging defines the extent of lung cancer in your body and guides your treatment. It tells you about the size of the tumor and how far it has spread. Stage 0 lung cancer has spread the least, while stage 4 has the most.

Understanding the lung cancer stages is important because it’s the first step in creating a plan for your lung cancer treatment. In general, lung cancer in the earliest stages is easier to treat. However, continued advances in care mean you now have even more options for later stages of lung cancer.

Regardless of stage, our lung cancer teams will guide you through your choices and answer your questions. Many of our locations offer advanced tools and tests that help with lung cancer staging and give you access to innovative treatment options so that you feel confident in the path ahead.

oncologist explaining to male patient about the stages of lung cancer

TNM staging for lung cancer

TNM staging for lung cancer is a system used by your care team. In lung cancer, TMN staging is commonly used for non-small cell lung cancer. If you have small-cell lung cancer, your team may use a different staging system.

TNM staging places your specific cancer into stages 0 to 4, as well as substages identified by three letters:

Tumor (T)

Your care team will look at the size and location of the tumor and how far it has spread in the lungs.

Node (N)

Cancer often spreads to nearby lymph nodes, which are part of your immune system. Your team will look for cancer that has spread to these regional nodes.

Metastasis (M)

When cancer spreads to other areas of the body, it’s called metastasis or metastatic lung cancer. Your care team will look for signs of lung cancer in distant areas like the liver, brain or bones.

Non-small cell lung cancer stages

The most common type of lung cancer is non-small cell lung cancer (NSCLC). It’s grouped into five different stages. Usually, the lower the stage number, the better the prognosis for treatment and long-term remission. Stage 0 and stage 1 are the earliest stages, where the cancer has not spread outside the lung. In stages 2, 3 and 4, the lung cancer has begun to spread to lymph nodes or other organs.

Our cancer teams are highly experienced in diagnosing and staging lung cancer. We offer advanced testing and expertise to help guide the staging process and give you the information you need to make informed choices about your care.

Stage 0 lung cancer

This first stage of lung cancer means that abnormal cells or cancer have only developed inside the lining of air passages in the lungs; they haven’t spread further into other lung tissues or other areas of the body. At stage 0, you may not have any symptoms, and this stage of lung cancer is often only found during an imaging test like a lung cancer screening.

If your team finds early-stage lung cancer on an imaging test, many of our locations offer specialized clinics to coordinate your care and connect you with treatment. The primary treatment for stage 0 lung cancer is surgery or endobronchial therapies, which help remove or destroy the cancer cells while preserving healthy lung tissue.

The two types of stage 0 lung cancer are:

Adenocarcinoma in situ: The abnormal cells are still “in place” where they started in the lining of the lung’s glandular tissue.
Squamous cell carcinoma in situ: The abnormal cells are still “in place” where they started in tissues that line the respiratory tract.

Small cell lung cancer stages

Usually, small-cell lung cancer is placed into one of two stages: limited-stage and extensive-stage cancer. In rare circumstances, your care team may use the TMN staging system.

Small-cell lung cancer tends to be faster-growing than non-small lung cancer and can quickly spread, reaching the extensive stage. Your treatment plan will be different based on your cancer stage, and our team will work with you to guide your next steps.

medical provider pointing out lung cancer on chest X-ray and explaining lung cancer stages

Recurrent lung cancer

Recurrent lung cancer is when your lung cancer is in remission for a year or more but then returns. It can reoccur in the same place (local recurrence), near the original tumor in lymph nodes (regional recurrence) or in areas far away from the original tumor (distant recurrence).

Unfortunately, recurrent lung cancer is relatively common. In non-small cell lung cancer, approximately 30% of people with stage 1 lung cancer have recurrent lung cancer, while more than 60% of stage 3 lung cancers return. In small-cell lung cancer, recurrence happens in as many as 70% of cases.

After lung cancer treatment, our team will continue to support you throughout your survivorship journey. You’ll have access to follow-up care and monitoring that can help you stay well and manage any signs of recurrence.

Treating recurrent lung cancer

Many of the same therapies used to treat your original lung cancer are options for recurrent lung cancer, such as chemotherapy, immunotherapy, radiation therapy, surgery, endobronchial therapies and clinical trials.

Depending on how advanced the recurrent cancer is and where it’s located, your treatment goals could aim to slow the new cancer’s growth or ease your symptoms. At our cancer centers, you’ll have resources and support to make the right choices for your treatment needs.

Some of our support resources include

Cancer support groups and programs

Cancer survivorship program

Supportive palliative care

Connect with certified navigators

With our certified navigators, you have an advocate by your side at every stage of your lung cancer journey—from diagnosis to survivorship. Whether you’re unsure where to turn, need help coordinating appointments or have a quick question, your certified navigator is your first point of contact for support and guidance.

Navigators connect you with the many support resources inside and outside our hospitals and clinics. And they are also available to help your family or caregivers get the support they need.

Find your patient navigator

nurse navigator placing hand on lung cancer patient's shoulder in support group

What is lung cancer staging?