What is staging?

After the diagnosis of small cell lung cancer is made, staging procedures are performed. These procedures are important in finding out where the disease is located, how best to treat the disease, identifies the sites of tumors that can be evaluated for response, and allows for a better assessment of prognosis.

The most common staging procedures used to document distant metastases (cancer that has spread to other parts of the body) may include:

· Bone marrow examination

· CT scans of the brain, chest, and abdomen (computed tomographic scans)

· MRI scans of the brain, chest, and abdomen (magnetic resonance imaging)

· Radionuclide bone scans

The detailed TNM staging system developed by the American Joint Committee on Cancer (AJCC) is not commonly used for patients with small cell carcinoma because some metastatic desease is present at diagnosis in most patients. A simple 2-stage system developed by the Veterans Administration Lung Cancer Study Group is more commonly used for staging small cell lung cancer patients. The two stages are limited stage and extensive stage small cell lung cancer.

Limited stage small cell lung cancer means that the tumor is confined to the lung from which it originated and in lymph nodes on the same side of the chest.

Extensive stage small cell lung cancer means that the cancer has spread to the other lung, to lymph nodes on the other side of the chest, or to distant organs. Many doctors consider small cell lung cancer which has spread to the fluid around the lung to be an extensive stage.

Small cell lung cancer is staged like this because it helps to separate tumors which can be treated more effectively with radiation therapy from those which cannot. About two-thirds of the people who have small cell lung cancer will have extensive disease when they are first diagnosed.