Small Cell Lung Cancer: Stages

What does stage of cancer mean?

The stage of a cancer is how much cancer there is and how far it has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. Scans can also show if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage 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 three key pieces of information: 

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

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

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

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

The T, N, and M values from the TNM system are used to put these cancers into stage groupings. The groupings give an overall description of your cancer. A stage grouping is listed as a Roman numeral and can have a value of I (1), II (2), III (3), or IV (4). The higher the number, the more advanced the cancer is.

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

Limited stage or extensive stage

Most healthcare providers prefer to divide SCLC into just two stages: limited or extensive. These are based on whether you may be helped by more intense treatments to try to cure the cancer, like chemotherapy combined with radiation therapy, or if chemo alone is a better choice to control more widespread cancer. Here are the three stages:

• Limited. In this stage, you have cancer only in one side of your chest. The cancer is in one lung, and maybe 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 one area and reach all the cancer.) About 1 in 3 people have limited-stage SCLC when first diagnosed.

• 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 (brain, bone, or bone marrow). About 2 in 3 people have extensive-stage SCLC when the cancer is first found.

Talking with your healthcare provider

Once your cancer is staged, talk with your healthcare provider about what the stage means for your treatment. Ask your healthcare provider to explain the details of your cancer to you in a way you can understand. Ask any questions and talk about your concerns.