How your lung cancer stage affects the treatment you’ll receive: Know your cancer roadmap

Understanding the stage of lung cancer disease is vital in understanding how best to treat a patient, says Russell K. Hales, M.D.

Hales, who is a radiation oncologist at the Johns Hopkins Kimmel Cancer Center on the Johns Hopkins Bayview campus, says there are four broad stages of lung cancer. He gives patients a way to think about the full spectrum of the disease as it progresses:

• Stage one lung cancer is “confined to tumors within the lung only, usually small, isolated nodules.”
• “The other end of the spectrum is stage four disease, a tumor that has spread to other areas of the body”
• “In the middle, between these two, is cancer that has spread to nearby areas, such as lymph nodes. That central area of the chest contains many lymph nodes and you can think of them as the on ramp to the rest of the body.  This is how cancer often spreads.  In order to fully stage a patient, we have to know if these lymph nodes are involved.  In patients who have larger tumors, or if these lymph nodes are involved, they would be stage two and three patients.”

Hales notes that stages can be divided into sub-stages for a more nuanced view. Early-stage disease is often treated with local therapy and more advanced lung cancer receives systemic treatment.

How are stages determined? “In order to complete a staging on patients, we not only evaluate the lymph nodes in the middle of the chest, but we also do a PET CT scan, to evaluate the body for any sites where disease may have spread, an MRI of the brain, and a biopsy,” Hales says.

Find out more from Dr. Hales about lung cancer, treatments for it, and innovative new research to help lung cancer patients in the free webinar, Lung Cancer: Serious Treatment for a Serious Cancer.