The most critical step of treatment for lung cancer is proper staging of the disease, which dictates which treatment combinations will be most effective. During a comprehensive diagnostic work up, our surgeons may perform a variety of  tissue biopsies and order radiographic imaging studies (CT/PET scans) to assess tumor size and whether the cancer has spread to nearby lymph nodes or other areas of the body.

Approximately 85% of lung cancers are classified as non-small cell lung cancer; small cell lung cancer accounts for the remaining 15%. Once diagnosed, non-small cell lung cancer is classified as one of five stages.


Stage 0 Lung Cancer

Stage 0 lung cancer is sometimes referred to non-invasive lung cancer, because it is limited to the lining of airways and has not invaded deeper into lung tissue or lymph nodes. When cancer is found at this stage, it can usually be cured through localized surgical resection or photodynamic laser therapy (PDT).

Stage 1 Lung Cancer

Stage I Lung Cancer describes a small tumor that is localized to the lungs and has not spread to nearby lymph nodes. At this stage, most patients do not experience significant symptoms. The cancer is often detected incidentally on X-ray or CT scans done for another reason or during lung cancer screening. Primary treatment involves surgical resection of the tumor in a minimally invasive procedure known as video-assisted (VATS) lobectomy. For patients who cannot physiologically tolerate a lobectomy, our surgeons may perform a wedge resection plus localized radiation (brachytherapy).

Stage 2 Lung Cancer

Stage II Lung Cancer describes a tumor that has begun to grow larger than 5 cm and may have spread to tissue surrounding the lungs such as nearby lymph nodes or the large bronchial tubes. Patients at this stage may begin to experience more severe symptoms of chest pain, shortness of breath, and/or coughing up blood. Depending on the specific tumor characteristics, treatment may involve a combination of surgical resection, chemotherapy, and/or radiation therapy.

Stage 3 Lung Cancer

Stage III Lung Cancer describes a large tumor that has spread to the mediastinal lymph nodes in the middle of the chest and possibly other tissues. Stage III is divided into two sub-stages: stage IIIA and stage IIIB. If the cancer remains localized to one side of the chest, it is classified as stage IIIA, while stage IIIB refers to cancer that has spread to lymph nodes on the other side of the chest or distant regions of the body. Stage III lung cancer is usually not treated surgically, instead requiring a highly individualized chemotherapy and/or radiation therapy regimen.

Stage 4 Lung Cancer

Stage IV Lung Cancer, also known as advanced stage lung cancer, describes a tumor that has spread to both lungs and other organs or parts of the body. Advanced stage lung cancer can cause more noticeable or severe symptoms, such as unexplained weight loss, coughing up blood, bone pain, and headaches. Chemotherapy is the main treatment option, while radiation therapy may be helpful in targeted regions. A newer class of cancer treatment, known as targeted drug therapy, may be attempted to slow the progression of disease if chemotherapy and radiation have proven ineffective.

Small Cell Lung Cancer

Small cell lung cancer, which is far less common than non-small cell lung cancer, is traditionally characterized as limited (confined to the chest) or extensive (spread to other areas of the body).  Early stage small cell lung cancer can rarely be removed surgically. In most cases, small cell lung cancer is treated with a combination of chemotherapy, radiation, and supportive care.

Contact an Expert Thoracic Surgeon

West Coast Thoracic Surgery is a Los Angeles-based practice dedicated to the comprehensive treatment of thoracic conditions and malignancies, directed by renowned thoracic surgeons Ali Mahtabifard, MD and Clark Fuller, MD. Having trained at some of the country’s most prestigious cancer institutions, Dr. Mahtabifard and Dr. Fuller are highly knowledgable and skilled in the most advanced minimally invasive thoracic surgical techniques for the treatment of lung cancer.

To learn more about the lung cancer staging and treatment, or to schedule your initial consultation with a Los Angeles thoracic surgeon, please call 310.854.0909 or fill out our online contact form.

Next, read about lung cancer stages 1 and 2.