An introduction to the stages of lung cancer

Posted: 8/6/2020 8:00 AM by Interim HealthCare
Chances are that you are somehow connected to someone who has been affected by lung cancer in their family. In fact, it is the second most common cancer among American adults (behind only skin cancer). 

The American Cancer Society predicts about 228,820 new cases of lung cancer this year, and about 135,720 deaths. Although most of us know by now that smoking causes lung cancer, there is a great deal to know and understand about this disease. In this post, we aim to create an introduction to the stages of lung cancer, plus more information to help you or a loved one.

Small cell versus non-small cell lung cancer

There are two main types of lung cancer: small cell (SCLC) and non-small cell. Quite literally, with small cell cancer the cancer cells appear small and round when examined under a microscope. In cases of non-small cell lung cancer, the cells are larger. 

Although smoking is a risk factor for both small cell and non-small cell lung cancer, 95% of people who receive a small cell lung cancer diagnosis have a history of smoking. 

Generally speaking, SCLC is considered more aggressive than non-small cell, although some types of cancer are more aggressive than others. 

Lung cancer risk factors

Most people automatically think "smoking" in conversations around lung cancer, and it IS the main risk factor for both small cell and non-small cell lung cancer. But, there are additional risk factors, including:

* Secondhand smoke exposure
* Excessive air pollution in your area
* Exposure to radiation in the past
* Living with HIV
* Chemical exposure (especially arsenic)
* Asbestos, nickel, chromium, soot or tar exposure
* Older age
* Family history of lung cancer

Lung cancer symptoms

The most common symptoms of lung cancer include:

* Hoarseness
* Persistent cough (with or without coughing up blood/mucus)
* Fatigue
* Wheezing/shortness of breath
* Difficulty swallowing
* Loss of appetite
* Pain and/or discomfort in the chest

Many of these symptoms can be caused by other ailments, or may fly under the radar -- especially in seniors who may be dealing with additional health issues. That's why it's especially important to talk to a doctor about any new, persistent or worsening symptoms.

Diagnosing lung cancer

Once you've followed up with a doctor regarding any of the symptoms noted above (or any questionable symptoms), your or your loved one's doctor will likely schedule an appointment to ask some questions and conduct a thorough medical examination.

If there are strong concerns about lung cancer, the doctor will likely recommend completing a lung x-ray or CT (CAT) scan. This imagery can give varying degrees of view into the lungs, and can help identify tumors, scarring or fluid buildup. A test may also be conducted on phlegm or mucus to provide additional insight. 

Following imagery and/or testing of phlegm, the results may warrant a biopsy to determine the presence of cancer cells and if so, what type of lung cancer is present. A bronchoscopy may be used to provide a few of lungs and take samples. During this procedure, a camera and tool are inserted through the mouth or nose and led down so that the doctor can view your lungs. 

Depending on the results of your initial testing, the doctor may also suggest additional testing to determine if the cancer has spread. 

The stages of lung cancer

When talking about lung cancer, we often think about the "stages" of cancer. The stage can refer to where a tumor or cancerous cells are located, how large the tumor is at present and if the cancer has spread. 

Most simply, lung cancer stages can be referred to as either "localized," when the cancer is in one place, "regional," when the cancer has spread to surrounding tissues and "distant," where the cancer has spread across the body. 

Doctors may also refer to stage "0" lung cancer when cancerous cells are not present, but precancerous cells that can turn malignant are found. Late stage or metatastic lung cancer means that the lung cancer has spread to other parts of the body and is significantly advanced.

Small cell and non-small cell lung cancer stages are referred to differently. Keep reading for an introduction to the stages of both types of lung cancer.

Small cell lung cancer stages

There are typically two stages of SCLC referred to by doctors:

1. Limited. In this stage, the small cell lung cancer is present in just one side of the chest. The lung and/or lymph nodes on that side may be affected, but the other lung does not have any cancer cells. Some doctors also consider cancer that has spread to lymph nodes in the center of the chest as limited.

2. Extensive. When SCLC is extensive, the cancer has spread to other parts of the chest and/or other organs (including bone marrow). Many doctors also consider cancer that has spread into the fluid around the lung as extensive.

Non-small cell lung cancer stages

At a high level, non-small cell lung cancer is typically broken down into four (4) stages (for a much more detailed look at differentiators between stages, see this resource from the American Cancer Society):

Stage 1. In this stage, the cancer is only present within the lungs, and the tumor is considered small.

Stage 2. During stage 2, the cancer has spread to the lymph nodes nearest the lungs.

Stage 3. When a patient is in stage 3, the cancer has spread to other lymph nodes in the chest, including the middle and opposite side of the tumor.

Stage 4. In stage 4, the cancer has spread into both lungs, and/or to other organs or parts of the body. 

Lung cancer treatment

In cases of SCLC, chemotherapy and/or radiation are typically used to manage the disease. Surgery and chemotherapy may be used if the cancer has not spread to the lymph nodes, although this occurs only rarely.

If you are facing an SCLC diagnosis, you'll be discussing all the options together with your doctor (and family members).

When facing a non-small cell lung cancer diagnosis, surgery may be an option to remove the cancerous cells and lymph nodes, however, the tumor size may affect the ability to treat using surgery. 

Chemotherapy and/or radiation are also used, and endoscopic stents are sometimes used if a tumor is blocking part of the airway. Immunotherapy helps boost your immune system's ability to fight the cancer, while targeted treatments may help stop or delay the growth of some non-small cell lung cancers.

We're with you, now and through whatever the future holds.

From home care to hospice, the compassionate and professional caregivers at Interim HealthCare help patients and their families dealing with a range of health challenges. From daily tasks to specialized treatments and so much more, we are here to help. Contact your nearest Interim HealthCare location to learn more.