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Stages of Lung Cancer

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Understanding your lung cancer stage is an important step in planning your care. This can feel overwhelming, so we’re here to guide you through what each stage means and what support is available, so you can feel informed and confident about your next steps. 

Here are the stages of lung cancer, and what each stage means:

  • Stage I: Cancer is small and only in the lung.
  • Stage II: Cancer is larger or has spread to nearby lymph nodes.
  • Stage III: Cancer has spread more widely in the chest.
  • Stage IV: Cancer has spread to other parts of the body.

Whether you are at high risk, have received an abnormal lung screening, or you've been diagnosed with lung cancer, you don't have to do this alone. Get answers and compassionate, expert care near you with CHRISTUS Health oncologists.

Lung Screening

Lung screenings can detect lung cancer early, when it’s most treatable. If you have a family history of lung cancer or a history of smoking, fill out this form, and a CHRISTUS representative will reach out via phone or email within 1-2 business days.

Stage I Lung Cancer

Stage I lung cancer is the earliest stage. This means the cancer is small and only seen in the lung--it hasn't spread to lymph nodes or other parts of the body. This is often when treatment can be most effective, with the highest survival rate.

Types of Stage I Lung Cancer

There are two main types:

  • Stage IA: The tumor is very small (less than 3 cm) and limited to one part of the lung.
  • Stage IB: The tumor is slightly larger (3-4 cm) and may be growing toward nearby structures but still has not spread to outside the lung.

How Stage I Differs

Compared to stages I-IV, stage I is less advanced. There are more options for treatments and a higher chance of successful outcomes.

Treatment Options for Stage I

  • Surgery: Often the main treatment to remove the cancer
  • Radiation or targeted therapy: May be recommended if surgery isn't possible. Your doctor and health care team will help determine the best treatment for you, based on your overall health and the size and location of the cancer.
  • Adjuvant therapy: In some cases, chemotherapy or immunotherapy may be recommended after surgery to reduce the risk of recurrence.

Outlook and Survival Rate for Stage I

Stage I lung cancer has a much more favorable survival rate compared to later stages. Many patients live long, cancer-free lives after treatment, especially if the cancer is detected through screening before it spreads, or before symptoms appear.

Stage II Lung Cancer

Stage II lung cancer means the cancer is larger than in stage I and may have spread to nearby lymph nodes, but it has not spread to further parts of the body. Treatment is still often effective, especially when detected early.

Types of Stage II Lung Cancer

There are two main types:

  • Stage IIA: The tumor is 4-5 cm and may have spread into nearby structures, but has not reached lymph nodes.
  • Stage IIB: The tumor may be any size and has spread to nearby lymph nodes, or it is larger and and growing into nearby tissues, but hasn't spread into distant parts of the body.

How Stage II Differs

Stage II is slightly more advanced than stage one, because the cancer may involve lymph nodes or larger areas of the lung. Mediastinoscopy or bronchoscopy may be recommended to see if the cancer has spread to your lymph nodes. Treatment is still focused on removing or destroying the cancer, but additional therapies may be needed. 

Treatment Options for Stage II

  • Surgery: Often the first line of treatment if the cancer can be removed.
  • Radiation therapy: May be used after surgery to ensure cancerous cells don't return, or if surgery isn't possible.
  • Chemotherapy: Commonly recommended after surgery to reduce the risk of recurrence.
  • Immunotherapy or targeted therapy: May be considered based on tumor type and genetic markers. Your doctor and care team will tailor treatment to your health and the cancer's characteristics.

Outlook and Survival Rate for Stage II

Stage II lung cancer has a positive outlook when treated quickly. Many patients respond well to combined treatments, especially when the cancer is detected before spreading further.

Stage III Lung Cancer

Stage III lung cancer means the cancer has spread within the chest, typically to nearby lymph nodes or tissues, but it hasn't reached distant organs. This stage can feel overwhelming, but there are treatment options that can help.

Types of Stage III Lung Cancer

  • Stage IIIA: Cancer has spread to lymph nodes on the same side of the chest as the primary tumor.
  • Stage IIIB: Cancer has spread to lymph nodes on the opposite side of the chest or above the collarbone, or into nearby structures like the chest wall.
  • Stage IIIC: Cancer has spread more extensively within the chest, often involving multiple lymph node regions and nearby organs.

How Stage III Differs

Compared to Stages I-II, stage III has spread and usually requires a combination of treatments rather than a single approach.

Treatment Options for Stage III

  • Chemotherapy: To shrink tumors and destroy cancer cells throughout the body.
  • Radiation therapy: Often combined with chemotherapy to target cancer in the chest.
  • Targeted therapy: Helps the immune system recognize and attack cancer cells.
  • Immunotherapy: Designed for patients whose cancer shows specific genetic mutations.
  • Surgery: In some cases, surgery may be beneficial after chemotherapy or radiation shrinks the tumor size.

Outlook and Survival Rate for Stage III

Stage III lung cancer is serious, but many people respond well to treatment. Survival rates vary based on factors such as type, the exact stage, overall health, and your body's response to therapy. While the stage III lung cancer survival rate is lower than in early stages, advances in treatment, such as targeted therapy and immunotherapy, are improving outcomes and offering new hope for patients. Talk to your care team for the most accurate outlook for your diagnosis.

Stage IV Lung Cancer

More than half of lung cancer cases are diagnosed at stage IV because early lung cancer often has few or no noticeable symptoms. Stage IV lung cancer is the most advanced stage. This means the cancer has spread beyond the lungs to other parts of the body, such as the brain, bones, or liver. This can feel overwhelming, but there are still treatments that can help manage symptoms and improve quality of life.

Types of Stage IV Lung Cancer

  • Stage IVA: The cancer has spread within the chest or to one area outside the chest, such as a single spot in the liver or brain.
  • Stage IVB: The cancer has spread to multiple areas outside the chest, such as several organs or distant lymph nodes.

How Stage IV Differs

In stage IV, the cancer is no longer confined to the chest. Treatment focuses on controlling the cancer, easing symptoms, and helping you live as fully as possible.

Treatment Options for Stage IV

  • Targeted therapy: Medicines that attack cancer cells with specific types of mutations.
  • Immunotherapy: Boosts the immune system to recognize and fight cancer.
  • Chemotherapy and radiation therapy: To shrink tumors and relieve symptoms.
  • Palliative and supportive care: If you decide, your treatment may be focused on managing pain and emotional well-being.

Outlook and Survival Rate for Stage IV

Stage IV lung cancer is the most advanced and serious stage of lung cancer. Survival rates vary widely based on your diagnosis, the type of cancer, your overall health, and how the cancer responds to therapy. Your health care team will work with you to determine the best treatment plan for you.

Answers and Support for Every Step

From lung cancer screenings to understanding symptoms and exploring advanced treatment options, our comprehensive care team is here to provide clarity, confidence, and compassionate support. With CHRISTUS Health, you have access to trusted resources and a large network of cancer care specialists dedicated to guiding you every step of the way.

A nurse listens to a senior man's heart and lungsScreenings and Detection

Get peace of mind with a quick, low-dose CT scan that helps find lung cancer early, so you can take action when it matters most.

Learn more about lung cancer screenings 

A 55 year old man is getting his heart and lungs checked by his doctorSigns and Symptoms

Notice changes early and take charge of your health. Know the signs of lung cancer for faster care, easier treatment and better outcomes.

Discover the signs and symptoms of lung cancer 

Treatment Options

Explore treatment options designed to help you fight lung cancer with confidence and improve your quality of life.

Learn about your treatment options 

Types of Lung Cancer

There are two main types of lung cancer:

  • Non-small cell lung cancer: The most common type of cancer, accounting for about 85 percent of cases. Subtypes include adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
  • Small cell lung cancer: Less common but more aggressive, often spreading more quickly.

Diagnosing Lung Cancer

Lung cancer is typically diagnosed after symptoms appear. Once cancer is confirmed, your health care team will need to understand the type, size, and how the cancer has spread to determine the best treatment plan.

These tests typically involve:

  • Imaging tests: Low-dose CT scans, chest X-rays, MRIs, or PET scans to spot tumors.
  • Biopsy: Removing a small sample of lung tissue for lab testing to determine the type of cancerous cells.
  • Mediastinoscopy or bronchoscopy: To see if the cancer has spread to the lymph nodes.
  • Staging tests: Determining the size of the tumor and if it has spread outside of the lungs, chest, or further.

Learn if You Are at Risk of Lung Cancer

Lung cancer is one of the leading causes of cancer deaths and one of the most preventable. To find out your risk, take the CHRISTUS Health lung cancer assessment.

Assess My Risk

Frequently Asked Questions About Lung Cancer Stages

What is the life expectancy with lung cancer? 
Life expectancy depends on many factors, including the stage at diagnosis, overall health, and how the cancer responds to treatment. Early-stage lung cancer often has amore positive outlook than advanced stages, but every case is different. Talk to your doctor about your diagnosis and your outlook.
How is lung cancer staging determined? 
Lung cancer staging is based on the size of the tumor, whether it has spread to lymph nodes, and whether it has reached other parts of the body. Doctors use imaging tests, biopsies, and sometimes surgical findings to determine the stage. This helps your health care team determine the best form of treatment.
What is the TNM staging system for lung cancer? 

TNM stands for Tumor, Node, Metastasis:

  • T: Tumor: Size and location of the main tumor.
  • N: Node: Whether cancer has spread to nearby lymph nodes.
  • M: Metastasis: Whether cancer has spread to distant organs.

Your doctor will use these factors to assign an overall stage of the diagnosis, stages I-IV.

 

Is lung cancer treatable if caught early? 
Yes, lung cancer found at an early stage (especially Stage I) is often highly treatable with surgery or targeted therapies. Early detection through screening offers the best chance for successful treatment.
Do you get chemotherapy for early-stage lung cancer? 
Not always. For stage I lung cancer, surgery is often the main treatment. Chemotherapy may be recommended after surgery in some cases or for higher-risk early stages. Your doctor will decide based on your specific situation.

Meet Our Lung Care Team