How is lung cancer diagnosed and staged?
Lung cancer is generally detected through multiple tests. Unfortunately, there is no single proven screening test for lung cancer. Testing may include:
Chest X-rays – A non-invasive imaging test that shows the size, shape and location of an abnormal cell growth but not if the growth is cancerous.
Imaging Tests such as Computed Tomography (CAT) scans, Positron Emission Tomography – Computed Tomography (PET/CT) scans and/or MRIs – Non-invasive imaging tests that utilize advanced computer technology to capture enhanced images of the organs that are more detailed than X-rays and may also reveal if cancer has spread to other organs.
Biopsy – Abnormal tissue growth is removed through a needle or through surgery, and the tissue is examined with a microscope to determine if it is cancerous (malignant) or non-cancerous (benign). Tests to determine the stage of lung cancer may include transbronchial biopsy and fine needle aspiration, thoracoscopic biopsy with CT-guided localization, mediastinoscopy, anterior mediastinotomy and thoracoscopic node sampling.
Bronchoscopy – During this procedure, the patient is sedated and the doctor inserts a bronchoscope to directly view the airways of the lung. Sometimes a biopsy of abnormal tissue is taken and examined with a microscope.
Lung Cancer Staging Criteria and Treatment
When lung cancer is detected, the physician then “stages” the lung cancer to determine how far it has progressed. Staging the lung cancer allows our thoracic cancer team to develop an optimal treatment plan. Lung cancer is staged two different ways depending upon whether it is diagnosed as small cell lung cancer or non-small cell lung cancer.
The thoracic cancer team at the Florida Hospital Cancer Institute offers a variety of therapy choices. Depending upon the stage of the lung cancer and other individual factors, the treatment plan varies from patient to patient. Generally, treatment for lung cancer can include surgery, radiation and/or chemotherapy.
Small Cell Lung Cancer Staging
Limited stage: The cancer is limited to one lung and the lymph nodes on the same side of the chest.
Extensive stage: The cancer has spread to the other lung, lymph nodes on the other side of the chest, and/or other organs.
Non-small Cell Lung Cancer Staging
Stage I: The cancer is found in one lung only and has not spread to lymph nodes or the other lung. The outlook is very hopeful when the cancer is found in this early stage. Treatment is usually surgical removal of the tumor. However, in some cases, chemotherapy is recommended is also recommended.
Stage II: The cancer has spread to the lymph nodes in the chest near the lungs. Treatment may include surgical removal of the tumor and chemotherapy and/or radiation to address the cancer in the lymph nodes.
Stage III-A: The cancer has spread to the lymph nodes away from the lungs in the middle of the chest, and the cancer in the lung is comprised of a single tumor. Treatment may start with chemotherapy and/or drug therapy and radiation, which may be followed by surgery depending upon the effectiveness of the initial treatment.
Stage III-B: The cancer has spread to the lymph nodes away from the lungs in the middle of the chest, and the cancer in the lung has spread to more than one area (i.e. multiple tumors in the lung). Treatment may be comprised of chemotherapy and radiation without surgery.
Stage IV: In this most advanced stage of lung cancer, the cancer has spread (metastasized) to distant parts of the body, such as the brains, bones, liver or other organs. Treatment may be comprised of chemotherapy, radiation therapy and/or other drug treatments.