What Are the Stages of Non-Small Cell Lung Cancer?

This content has been reviewed and approved by

Chandra P. Belani, MD
Deputy Director, Penn State Cancer Institute
Miriam Beckner Professor of Medicine
Penn State University School of Medicine

Stages of cancer relate to how far the cancer has spread in your body. The higher the stage, the more widespread the cancer. These stages are important in determining the type of treatment you will receive and your overall prognosis.

The stages of non-small cell lung cancer (NSCLC) differ from those of small cell lung cancer. Non-small stages are based on how far the cancer has spread, the size of tumors, and whether cancer has traveled into the lymph nodes or distant sites. The stages are:

Stage I - Cancer is located in only one lung. It has not spread to the adjacent lymph nodes or outside the chest.

Stage II - The cancer is located in one lung and may involve lymph nodes on the same side of the chest (close to the airways and/or the root of the lung). It does not include lymph nodes in the space between the lungs (the mediastinum) or outside the chest.

Stage IIIA - The cancer is a single tumor or mass that is not invading any adjacent organs but  has invaded the chest wall. It also can involve one or more lymph nodes on the same side of the mediastinum.

Stage IIIB - The cancer has spread to the lymph nodes in the opposite mediastinum, beneath the clavicle (the bony parts just under your neck), is associated with the presence of fluid (pleural effusion), involves more than one area in the same lobe and, more often than not, cannot be surgically removed.

Stage IV - Cancer has spread (metastasized) to different sites in the body beyond the chest, including the liver, brain, or other organs, or to the other lung.

Recurrent/relapsed - The cancer has progressed or returned (recurred/relapsed) following an initial treatment with surgery, radiation therapy, and/or chemotherapy.