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Lung cancer stages

Making an educated treatment decision begins with the stage, or progression, of the disease. Using the results from your diagnostic tests, your care team at Cancer Treatment Centers of America® (CTCA) will develop an appropriate treatment plan for you.

If you have been recently diagnosed, we will review your pathology to confirm you have received the correct diagnosis and staging information, and develop a personalized treatment plan for you. If you have had a cancer recurrence, we will perform comprehensive testing and identify a treatment approach tailored to your needs.

Stage 2 Non-Small Cell Lung Cancer

Stage II non-small cell lung cancer (NSCLC), like stages 0, IA and IB, is considered a localized cancer.These tumors are larger than those in stage I (less than 7 cm wide), and have begun to spread to nearby lymph nodes or other nearby structures. The cancer has not spread to distant organs. 

About 30 percent of lung cancers are diagnosed at this stage, and the treatment success rate is higher than later stages because the cancer is still contained in the vicinity of the lungs. For patients who complete treatment, the five-year survival rate is about 20 – 30 percent, with stage IIA lung cancer on the higher end of the spectrum.

Stage II non-small cell lung cancer is divided into stage IIA and IIB, with each stage then broken into additional sections, depending on the size of the tumor, where it is found, and whether or not the cancer has spread to the lymph nodes.

Stage IIA lung cancer

For patients diagnosed with stage IIA non-small cell lung cancer, the tumor is larger than 5 cm but less than 7 cm wide and has not spread to nearby lymph nodes. The diagnosis is the same when the tumor is less than 5 cm wide and has spread to nearby lymph nodes contained within the lung.  

TNM categories of stage IIA

When the stage IIA lung cancer tumor has spread to the lymph nodes, which would be characterized as N1 on the TNM scale, the cancer is staged as either T1A/T1B, N1, M0 or T2A, N1, M0. The M0 designation indicates for both cases that the cancer has not yet spread to other organs.

T1A/T1B, N1, M0

  • The tumor is either 2 cm or less (T1A) or larger than 2 cm but smaller than 3 cm (T1B).
  • The cancer has not grown into the membranes surrounding the lungs.
  • The main branches of the bronchi are not affected.
  • The cancer has spread to lymph nodes within the lungs and around the location where the bronchus connects to the lung.

T2A, N1, M0

The cancer has one or more of the following features:

  • The tumor is larger than 3 cm but smaller than 5 cm.
  • Cancer has spread to the main bronchus and is at least 2 cm below the carina, the cartilaginous ridged area that separates the opening of the right and left main bronchi stems.
  • Cancer has spread to the lining of the lung.
  • Part of the lung has collapsed or developed an inflammation in the carina, which can partially clog the patient’s airways.

If the cancer has not spread to the lymph nodes, it is known as T2B, N0, M 0. The cancer will have one or more of same features listed above, except the T2B stage indicates that the tumor is between 5 and 7 cm.

Stage IIB non-small cell lung cancer

Stage IIB lung cancer also has two different subcategories, depending on the size of the tumor and whether or not it has spread to the lymph nodes.

For each category, one or more of the features listed below will be present.

T2B, N1, M0

  • The tumor is between 5 and 7 cm.
  • Cancer has spread to the main bronchus and is at least 2 cm away from the carina.
  • Cancer has spread to the lining of the lung.
  • Part of the lung has collapsed or developed an inflammation in the carina, which can partially clog the patient’s airways.

T3, N0, M0

If the cancer has not spread to the lymph nodes, it is classified as T3, N0, M0 and one or more of the following features will be present:

  • The tumor is larger than 7 cm.
  • The tumor has expanded into the chest wall, the diaphragm, the membranes present in the space between the lungs or the membranes located in the sac surrounding the heart.
  • The cancer has spread into the main bronchus and is within 2 cm of the carina, but does not actually affect the carina.
  • The airways are blocked enough that the entire lung could collapse or become inflamed.
  • Two or more separate tumors are present within the same lobe of one lung.

Common treatments for stage II non-small cell lung cancer: Patients with stage II non-small cell lung cancer who can tolerate surgery typically have a lobectomy or sleeve resection to remove the cancer. Sometimes, removing the whole lung is recommended. Lymph nodes likely to contain cancerous cells may also be removed. In some cases, chemotherapy (often combined with radiation) may be recommended in an effort to shrink the tumor before surgery to remove it.

We also provide therapies to ease the symptoms that can be associated with NSCLC, while improving your quality of life.

How is lung cancer staged?

daniel nader

Staging is very important because the stage of the lung cancer dictates treatment. Dr. Nader describes how lung cancer is staged by using intrabronchial ultrasound and navigational bronchoscopy, followed by a non-surgical needle biopsy.

What is the difference between small and non-small lung cancer?

Dr. Weiss explains the difference between the two most common types of lung cancer, small-cell and non-small cell.

They are diagnosed by pathologists who examine tissue under a microscope to look for certain types of proteins in order to determine the cancer type.

Recent advancements in lung cancer treatment

In this explanation of innovative therapies, Dr. Nader talks about several treatment options, including intratumoral chemotherapy, brachytherapy, genomics and stereotactic radiation therapy.

The video also covers advancements in chemotherapy made possible by genomic tumor assessment and precision medicine.

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