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Lung Cancer TNM staging

TNM staging

Get details about the tumour, node and metastasis (TNM) staging system for lung cancer.

The stage of a cancer tells you the way large it’s and whether or not it has unfold. Understanding the stage helps your physician determine which treatment you want.

Your scans and checks will give some details about the stage of your cancer. However your physician may not have the ability to inform you the precise stage till after you’ve got surgical procedure.

The TNM staging system is the commonest means for medical doctors to stage non small cell lung cancer. And it’s typically used for small cell lung cancer.

TNM stands for Tumour, Node, Metastasis.

Medical doctors use the TNM system to create a quantity staging system: with Stages 1 to four.

Medical doctors generally use a less complicated staging system for small cell lung cancer. They could describe it as restricted illness or intensive illness.

Tumour (T)

Tumour describes the dimensions of the tumour (space of cancer). It is a simplified description of the T stage.

There are four classes – T1 to T4.

TX means the primary cancer (main) can’t be assessed. It does not present on scans however there may be cancer cells current in spit or in fluid taken from the lung.

T0 means there is no such thing as a signal of cancer.

Tis means an space of cancer cells contained inside the inside lining of the lungs.


T1 means the cancer is contained inside the lung.

It’s divided into T1a, T1b, and T1c in keeping with the diameter of the cancer.

T1a means the cancer is 1cm or much less at its widest half.

T1b means the cancer is between 1cm and 2cm throughout.

T1c means the cancer is between 2 and three cm throughout.


T2 can imply various things.

The cancer is between 3cm and 5cm throughout.

Or the cancer has a number of of the next options:

  • it entails the principle airway (the primary bronchus) however will not be near the realm the place the bronchus divides to enter every lung
  • it includes the inside lining of the chest cavity (the visceral pleura)
  • half or the entire lung has collapsed or is blocked as a consequence of irritation

T2 is split into T2a and T2b.

T2a means the cancer is between 3cm and 4cm.

T2b means the cancer is between 4cm and 5cm.


T3 can imply various things.

The cancer is between 5cm to 7cm.

Or there’s multiple tumour in the identical lobe of the lung.

Or the cancer has grown into a number of of those constructions:

  • the chest wall (the constructions across the lungs, akin to ribs, muscle groups, cartilage, or the diaphragm)
  • the nerve near the lung (phrenic nerve)
  • the outer overlaying of the guts (the pericardium)


T4 can imply various things.

The cancer is larger than 7cm.

Or it’s in a couple of lobe of the lung.

Or it has unfold into a number of of the next constructions:

  • the muscle underneath the lungs (the diaphragm)
  • the world between the lungs in the course of the chest (the mediastinum)
  • the guts
  • a significant blood vessel
  • the wind pipe (trachea)
  • the nerve that controls the voice field
  • the meals pipe (oesophagus)
  • a spinal bone
  • the realm the place the principle airway divides to go to every lung

Node (N)

Node (N) describes whether or not the cancer has unfold to the lymph nodes.

NX implies that the lymph nodes can’t be assessed.

N0 implies that the lymph nodes don’t include cancer cells.


N1 means there are cancer cells in lymph nodes throughout the lung or in lymph nodes within the space the place the lungs be a part of the airway (the hilum).


N2 means there’s cancer in lymph nodes:

  • within the centre of the chest (mediastinum) on the identical facet because the affected lung or
  • just below the place the windpipe branches off to every lung


N3 means there may be cancer in lymph nodes:

  • on the alternative facet of the chest from the affected lung or
  • above the collar bone or
  • on the high of the lung

Metastasis (M)

Metastasis (M) describes whether or not the cancer has unfold to a distinct a part of the physique.

M0 and M1

There are 2 Stages of metastasis – M0 and M1.

M0 means the cancer hasn’t unfold to a different lobe of the lung or every other a part of the physique

M1 means the cancer has unfold to different areas of the physique. It’s break up into M1a, M1b and M1c.

M1a means a number of of the next:

  • there may be cancer in each lungs
  • there are areas of cancer across the coronary heart or within the lining across the lung
  • there may be fluid across the lung or coronary heart that comprises cancer cells – that is known as a malignant pleural effusion or a pericardial effusion

M1b means that there’s a single space of cancer exterior the chest in an organ (such because the liver or mind) or a lymph node.

M1c means that there’s multiple space of cancer in a single or a number of organs.


The stage of your cancer helps your physician to resolve which treatment you want. Treatment additionally is determined by:

  • your kind of cancer (the kind of cells the cancer began in)
  • the place the cancer is
  • different well being situations that you’ve

The stage of the cancer and these different elements also can give an thought of your outlook (prognosis).

Treatment would possibly embody a number of of the next:

  • chemotherapy
  • radiotherapy
  • chemoradiation – chemotherapy with radiotherapy
  • surgical procedure – to take away half or your whole lung
  • focused cancer medication
  • radiofrequency ablation
  • photodynamic remedy
  • symptom management treatment


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