Doctors typically divide small cell lung cancer (SCLC) into limited or extensive stages, depending on whether the cancer is in one lung, both lungs, or has spread to distant areas.
Staging for small cell lung cancer (SCLC) can help identify how advanced the cancer is and its best treatment.
In addition to the “limited” or “extensive” stages, doctors also classify SCLC into stages relating to the size and location of the tumor and whether the cancer has spread to the lymph nodes or distant organs. This article looks at the systems doctors use to stage SCLC.
Doctors use results from diagnostic tests to determine the stage of SCLC. These
- physical exams
- biopsies
- imaging tests, such as MRI and CT scans
- bronchoscopy
- lung function tests
The results of these tests can show doctors the size and location of a tumor, any lymph node involvement, and whether the cancer has spread to distant areas. This information allows doctors to stage SCLC.
Limited-stage SCLC occurs
Treatments, such as chemotherapy with radiation therapy, may work to cure limited-stage SCLC.
Extensive-stage SCLC means the cancer has spread throughout one or both lungs or to other parts of the body.
There is no cure for extensive-stage SCLC, but treatments, such as chemotherapy and immunotherapy,
Doctors use the American Joint Committee on Cancer (AJCC) TNM staging system to classify cancer based on the following factors:
- T: This indicates the size and location of the tumor (T) and whether it has spread to surrounding areas.
- N: This indicates whether the cancer has spread to nearby lymph nodes (N).
- M: This indicates whether there is metastasis (M), which is the spread of cancer to distant areas of the body.
Doctors then assign additional numbers or letters to describe each factor.
Doctors use the American Joint Committee on Cancer (AJCC) TNM system to stage lung cancer, although it is typically used more for non-small cell lung cancer than SCLC, which doctors more often categorize as extensive or limited-stage.
The TNM stages range
Occult, or hidden, cancer is before stage 0. At the occult stage, doctors cannot identify the location of the lung cancer but do not think it has spread to lymph nodes or distant areas. Cancer cells may appear in lung fluid samples but do not show on other tests.
Stage 0
| AJCC stage | 0 |
|---|---|
| Stage grouping | Tis N0 M0 |
| Stage description | • The tumor has not spread deeper within lung tissue (Tis). • There is no spread to lymph nodes (N0) or distant areas (M0). |
Stage 1
| AJCC stage | 1A1, 1A2, or 1A3 |
|---|---|
| Stage grouping | T1mi or T1a, T1b, or T1c N0 M0 |
| Stage description | • The tumor is minimally invasive (mi) and no larger than 3 centimeters (cm) across. • There is no spread to lymph nodes or distant areas. |
| AJCC stage | 1B |
|---|---|
| Stage grouping | T2a N0 M0 |
| Stage description | • The tumor is more than 3 cm but less than 4 cm across. • There is no spread to lymph nodes or distant areas. |
Stage 2
| AJCC stage | 2A |
|---|---|
| Stage grouping | T2b N0 M0 |
| Stage description | • The tumor is larger than 4 cm but less than 5 cm across. • There is no spread to lymph nodes or distant areas. |
| AJCC stage | 2B |
|---|---|
| Stage grouping | T1a, T1b, or T1c; T2a or T2b; or T3, depending on tumor growth N0 or N1 M0 |
| Stage description | • The tumor size ranges from no larger than 3 cm to less than 5 cm across. • There is spread to the lymph nodes on the same side as the cancer. OR • The tumor is larger than 5 cm but less than 7 cm and has not spread to lymph nodes. • No spread to distant areas. |
Stage 3
| AJCC stage | 3A |
|---|---|
| Stage grouping | T1a, T1b, or T1c; T2a or T2b; T3; or T4 N0, N1, or N2 M0 |
| Stage description | • The tumor size ranges from no larger than 3 cm to larger than 7 cm, depending on stage T grouping. • The cancer may have spread to lymph nodes on the same side as the cancer but not to distant areas. |
| AJCC stage | 3B |
|---|---|
| Stage grouping | T1a, T1b, or T1c; T2a or T2b; T3; or T4 N2 or N3 M0 |
| Stage description | • The tumor size ranges from no larger than 3 cm to larger than 7 cm, depending on stage T grouping. • The cancer may have spread to lymph nodes on either side of the original tumor, but not to distant areas. |
| AJCC stage | 3C |
|---|---|
| Stage grouping | T3 or T4 N3 M0 |
| Stage description | • The tumor measures more than 5 cm but less than 7cm (T3) or more than 7 cm (T4) across and has grown into certain areas of the chest. • The cancer has spread to lymph nodes away from the main tumor but not to distant areas. |
Stage 4
| AJCC stage | 4A |
|---|---|
| Stage grouping | Any T Any N M1a or M1b |
| Stage description | • Any size and nearby spread of the tumor, which may or may not include the lymph nodes. • The cancer has spread to the other lung, the lining, or the fluid around the heart or lung (M1a) OR • There is a single tumor in a distant area (M1b). |
| AJCC stage | 4B |
|---|---|
| Stage grouping | Any T Any N M1c |
| Stage description | • Any size and nearby spread of the tumor, which may or may not include the lymph nodes. • The cancer has spread to more than one tumor in a distant area. |
How quickly does small cell lung cancer progress?
SCLC grows and spreads quickly. The doubling time of cancer describes how quickly a tumor doubles in size. The doubling time of SCLC may be around 25 to 30 days.
Is small cell lung cancer considered terminal?
SCLC is
What is the life expectancy of someone with small cell lung cancer?
Without treatment, the life expectancy with SCLC is around
Read more about the life expectancy of someone with SCLC.
Doctors use the results of diagnostic tests to stage small cell lung cancer (SCLC). Staging identifies the extent of the tumor, lymph node involvement, and whether the cancer has spread to distant areas of the body.
Staging cancer helps doctors identify how advanced the cancer is and decide on the best course of treatment.