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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 ways large it’s and whether or not it has unfold. Realizing the stage helps your physician resolve which treatment you want.

Your scans and checks will give some details about the stage of your cancer. However your physician may not be capable of let you know the precise stage till after you will have surgical procedure.

The TNM staging system is the most typical means for docs to stage non small cell lung cancer. And it’s generally used for small cell lung cancer.

TNM stands for Tumour, Node, Metastasis.

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

Docs generally use an easier staging system for small cell lung cancer. They may describe it as restricted illness or in depth illness.

Tumour (T)

Tumour describes the dimensions of the tumour (space of cancer). This can be 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 would not present on scans however there is likely to be cancer cells current in spit or in fluid taken from the lung.

T0 means there isn’t any signal of cancer.

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


T1 means the cancer is contained throughout the lung.

It’s divided into T1a, T1b, and T1c in accordance 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 primary airway (the primary bronchus) however just isn’t near the realm the place the bronchus divides to enter every lung
  • it entails the internal lining of the chest cavity (the visceral pleura)
  • half or all the lung has collapsed or is blocked attributable to 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 may be 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 buildings across the lungs, similar to ribs, muscular tissues, cartilage, or the diaphragm)
  • the nerve near the lung (phrenic nerve)
  • the outer overlaying of the center (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 beneath the lungs (the diaphragm)
  • the world between the lungs in the midst of the chest (the mediastinum)
  • the center
  • a serious 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 comprise cancer cells.


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


N2 means there’s cancer in lymph nodes:

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


N3 means there’s cancer in lymph nodes:

  • on the other facet of the chest from the affected lung or
  • above the collar bone or
  • on the prime 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 another 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’s cancer in each lungs
  • there are areas of cancer across the coronary heart or within the lining across the lung
  • there’s fluid across the lung or coronary heart that incorporates cancer cells – that is referred to 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 determine which treatment you want. Treatment additionally will depend on:

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

The stage of the cancer and these different elements may give an concept of your outlook (prognosis).

Treatment may embrace a number of of the next:

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

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