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Limited and extensive stage (small cell lung cancer)

The stage of a cancer tells you how big it is and whether it has spread. Knowing the stage helps your doctor decide which treatment you need.

For help deciding on treatment, doctors might use a simple system to stage small cell lung cancer. This describes your cancer as limited disease or extensive disease.

Limited disease

Doctors describe small cell lung cancer as limited if the cancer is contained in a single area on one side of the chest. And the cancer can be treated with radiotherapy to just one area.

This generally means your cancer:

  • is only in one lung
  • may be in nearby lymph nodes – for example, in the centre of the chest or above the collar bone

If you have limited disease you are likely to have chemotherapy as well as radiotherapy treatment. This is sometimes called chemoradiotherapy.

Some people also have surgery.

Extensive disease

Extensive disease means that the cancer has spread beyond a single area that can be treated with radiotherapy.

It might have spread:

  • within the chest (either to the other lung or to lymph nodes further away from the cancer)
  • or to other parts of your body

Or there may be cancer cells in the fluid around the lung (a malignant pleural effusion).

The main treatment for extensive stage disease is chemotherapy.

TNM and number staging systems

Staging using limited and extensive disease is becoming less common. Doctors are using the TNM and number staging systems more regularly. This is because we are learning more about SCLC and how best to treat the different stages.

TNM and number stages for limited and extensive stage SCLC

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

  • T describes the size of the tumour
  • 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

Limited disease

In the TNM staging system limited disease is the same as any T, any N, M0.

This generally means stage 1, 2 and 3 SCLC.

Extensive disease

Extensive disease is the same as:

  • any T, any N, M1a
  • any T, any N, M1b
  • any T any N, M1c

Some people might have T3 or T4 tumours that are too big to be treated with radiotherapy to just one area.

Generally, extensive disease means a stage 4 small cell lung cancer.

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
Last reviewed: 
29 Jan 2020
  • TNM Classification of Malignant Tumours (8th edition)
    International Union Against Cancer   
    L H Sobin, M K Gospodarowicz, C H Wittekind
    John Wiley and Sons, Hoboken, New Jersey, 2017

  • AJCC Cancer Staging Manual (8th Edition)
    American Joint Committee on Cancer, 2017

  • The IASLC Lung Cancer Staging Project: Proposals for Revision of the TNM Stage Groupings in the Forthcoming (Eighth) Edition of the TNM Classification for Lung Cancer
    P Goldstraw and others for the Study of Lung Cancer Staging and Prognostic Factors Committee
    Journal of Thoracic Oncology, 2015. Volume 11, Number 1

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