Stage 1 lung cancer

The stage of a cancer tells you how big it is and whether it has spread. It helps your doctor decide which treatment you need. It can also give some idea of your outlook (prognosis).

Stage 1 is part of the number staging system. It uses the TNM system to divide cancers into stages. There are 4 stages of lung cancer, numbered from 1 to 4.

Stage 1 can be divided into 1A and 1B.

Stage 1A

There are 3 possible stages for stage 1A, namely stages 1A1, 1A2 and 1A3.

Stage 1A1 means:

  • the cancer is a minimally invasive adenocarcinoma. Adenocarcinoma is a type of non small cell lung cancer
  • the cancer is no more than 3cm at it’s widest part. It’s grown no further than 0.5cm into deeper lung tissue
  • it has not spread to nearby lymph nodes
  • it has not spread to distant parts of the body
Diagram 1 of 2 showing stage 1A1 lung cancer

Or stage 1A1 means:

  • the cancer is 1cm or less at its widest part
  • it has not grown into the membranes that surround the lungs (pleura)
  • it has not grown into the main branches of the airways
  • it has not spread to nearby lymph nodes
  • it has not spread to distant parts of the body
Diagram 2 of 2 showing stage 1A1 lung cancer

Stage 1A2 means:

  • the cancer is between 1cm and 2cm
  • It has not grown into the membranes that surround the lungs (pleura)
  • it has not grown into the main branches of the airways
  • it has not spread to nearby lymph nodes
  • it has not spread to distant parts of the body
Diagram showing stage 1A2 lung cancer

Stage 1A3 means:

  • the cancer is between 2cm and 3 cm
  • it has not grown into the membranes that surround the lungs (pleura)
  • it has not grown into the main branches of the airways
  • it has not spread to nearby lymph nodes
  • it has not spread to distant parts of the body
Diagram showing stage 1A3 lung cancer

Stage 1B

Stage 1B means one or more of the following:

  • the cancer is between 3cm and 4cm
  • it is smaller than 4cm and has grown into the main airway of the lung (main bronchus)
  • it is smaller than 4cm and has grown into the membrane covering the lung (visceral pleura)
  • it is smaller than 4cm and has caused the lung to partly or completely collapse by blocking the airway or causing inflammation of the lung tissue (pneumonitis)
Diagram showing stage 1B lung cancer

TNM stages

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour (cancer)
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

In the TNM staging system, stage 1A is the same as T1a-c, N0, M0.

Stage 1B is the same as T2a, N0, M0

Treatment

The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • your type of cancer (the type of cells the cancer started in)
  • where the cancer is
  • other health conditions that you have

The treatment for small cell lung cancer is different to the treatment for non small cell lung cancer.

Non small cell lung cancer

If you have surgery

If you are fit enough, you usually have surgery to remove

  • part of your lung (a lobectomy, segmentectomy or wedge resection)
  • all of the lung (pneumonectomy), depending on where the cancer is

Your fitness for surgery depends on your general health and how well you are likely to recover.

After surgery your doctor might offer you chemotherapy, immunotherapy Open a glossary itemor treatment with a targeted cancer drug Open a glossary item. This lowers the chance of your cancer coming back. It is called adjuvant treatment.

If your surgeon is not able to remove all of your tumour, you might have radiotherapy after surgery.

If you're not having surgery

If you aren’t fit enough for surgery or you decide that you don't want to have it, you might have:

  • radiotherapy - this is usually stereotactic ablative body radiotherapy (SABR) Open a glossary item. If you can’t have SABR, you might have conventional radiotherapy or radiotherapy that is divided into small doses and given more often, also known as continuous hyperfractionated accelerated radiotherapy (CHART)
  • chemotherapy after radiotherapy (adjuvant chemotherapy)
  • radiofrequency ablation Open a glossary item

Small cell lung cancer

Chemotherapy followed by radiotherapy to the chest is the main treatment for small cell lung cancer if you are not well enough to have chemoradiotherapy. 

If you are fit enough, you might have chemoradiotherapy. This means you have chemotherapy at the same time as radiotherapy. This is usually during your first or second cycle of chemotherapy.

Some people have surgery to remove all or part of the lung, especially in the early stage of cancer. But this is rare in small cell lung cancer. It is not usually possible to remove all of the cancer with surgery. After surgery, you have chemotherapy and possibly radiotherapy.

After you finish treatment, you might have radiotherapy to your head. This treatment is called prophylactic cranial radiotherapy Open a glossary item (PCR). You have this because it is quite common for small cell lung cancer to spread to the brain. The radiotherapy aims to kill any cancer cells that may have already spread to the brain but are still too small to see on scans.

You might have prophylactic cranial radiotherapy for limited stage disease if:

  • your chemotherapy or radiotherapy treatment has stopped your cancer growing
  • you are well enough

Other stages of lung cancer

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