Lung Cancer Staging

Cancer has formed. Stage I is divided into stages IA and IB:

• Stage IA: The tumor is in the lung only and is 3 centimeters or smaller.
  
  
  
• Stage IB: One or more of the following is true:
  • The tumor is larger than 3 centimeters.
  • Cancer has spread to the main bronchus of the lung, and is at least 2 centimeters from the carina (where the trachea joins the bronchi).
  • Cancer has spread to the innermost layer of the membrane that covers the lungs.
  • The tumor partly blocks the bronchus or bronchioles and part of the lung has collapsed or developed pneumonitis (inflammation of the lung).
  
  

Stage II is divided into stages IIA and IIB:

• Stage IIA: The tumor is larger than 4 centimeters but not larger than 5 centimeters or smaller and cancer has spread to nearby lymph nodes on the same side of the chest as the tumor.
  
  
  
• Stage IIB (1):
  The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following may be found:
  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.
  
  
  OR
• Stage IIB (1):
  The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following may be found:
  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.
  
  

Stage III is divided into stages IIIA, IIIB, IIIC:

• Stage IIIA (1): The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta, or where the trachea divides into the bronchi. Also, one or more of the following may be found:
  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.
  
  
  OR
• Stage IIIA (2): Cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:
  • The tumor is larger than 5 centimeters but not larger than 7 centimeters.
  • There are one or more separate tumors in the same lobe of the lung as the primary tumor.
  • Cancer has spread to any of the following:
    • The membrane that lines the inside of the chest wall.
    • The nerve that controls the diaphragm.
    • Outer layer of tissue of the sac around the heart.
  
  
  OR
• Stage IIIA (3): Cancer may have spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:
  • The tumor is larger than 7 centimeters.
  • There are one or more separate tumors in a different lobe of the lung with the primary tumor.
  • The tumor is any size and cancer has spread to any of the following:
    • Trachea.
    • Carina.
    • Esophagus.
    • Breastbone or backbone.
    • Diaphragm.
    • Heart.
    • Major blood vessels that lead to or from the heart (aorta or vena cava).
    • Nerve that controls the larynx (voice box).
  
  
  
  
• Stage IIIB (1): The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following may be found:
  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.
  
  
  OR
• Stage IIIB (2): The tumor may be any size and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta, or where the trachea divides into the bronchi. Also, one or more of the following is found:
  • There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor.
  • Cancer has spread to any of the following:
    • The membrane that lines the inside of the chest wall.
    • Chest wall.
    • The nerve that controls the diaphragm.
    • Outer layer of tissue of the sac around the heart.
    • Trachea.
    • Carina.
    • Esophagus.
    • Breastbone or backbone.
    • Diaphragm.
    • Heart.
    • Major blood vessels that lead to or from the heart (aorta or vena cava).
    • Nerve that controls the larynx (voice box).
  
  
  
  
• Stage IIIC: The tumor may be any size and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following is found:
  • There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart (aorta or vena cava).
  • Nerve that controls the larynx (voice box).