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Stage 2

Find out what stage 2 lung cancer means and about treatments.

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 2 is part of the number staging system. It can be divided into stage 2A and 2B. Part of the affected lung might have collapsed.

Stage 2A

Stage 2A means that the cancer is between 4cm and 5cm in size but there are no cancer cells in any lymph nodes.

Diagram showing stage 2A lung cancer

Stage 2B

Stage 2B means that the cancer is up to 5cm in size and there are cancer cells in the lymph nodes close to the affected lung.

 

Diagram 1 of 4 showing stage 2B lung cancer

Or it is between 5cm and 7cm but there are no cancer cells in any lymph nodes.

Diagram 2 of 4 showing stage 2B lung cancer

Or the cancer is not in any lymph nodes but has spread into one or more of the following areas:

  • the chest wall (ribs, muscle or skin)
  • the nerve close to the lung (the phrenic nerve)
  • the layers that cover the heart (mediastinal pleura and parietal pericardium)
Diagram 3 of 4 showing stage 2B lung cancer

Or the cancer is less than 7cm but there is more than one tumour in the same lobe of the lung.

Diagram 4 of 4 showing stage 2B lung cancer

TNM stages

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

In the TNM staging system stage 2A is the same as:

  • T2b, N0, M0

Stage 2B is the same as one of the following:

  • T1a-c, N1, M0
  • T2a-b, N1, M0
  • T3, 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)

After surgery, your doctor might suggest you have chemotherapy to lower the chance of your cancer coming back. This is called adjuvant chemotherapy.

If the surgeon couldn’t remove all the cancer you might have radiotherapy after your operation.

If you can't have surgery

If you aren’t fit enough for surgery you might have:

  • radiotherapy
  • or chemotherapy with radiotherapy (chemoradiation)

Small cell lung cancer

The main treatment is chemotherapy, followed by radiotherapy to the chest. 

If you are fit enough you might have chemoradiotherapy. This means you have chemotherapy at the same time as radiotherapy.

After you finish treatment, you might have radiotherapy to your head. This treatment is called prophylactic cranial radiotherapy (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 have might have prophylactic cranial radiotherapy if:

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

Other stages

Last reviewed: 
01 Aug 2017
  • TNM Classification of Malignant Tumours (8th edition)
    International Union Against Cancer   
    John Wiley and Sons, 2016

  • AJCC Cancer Staging Manual (8th edition)
    American Joint Committee on Cancer
    Springer, 2016

  • Lung cancer: diagnosis and management
    National Institute for Health and Care Excellence, 2011

  • Management of lung cancer
    Scottish Intercollegiate Guideline Network, 2014

  • 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
    Peter Goldstraw and others for the Study of Lung Cancer Staging and Prognostic Factors Committee
    Journal of Thoracic Oncology, 2015, vol.11, No.1:39-51

  • Guidelines on the Radical Management of Patients with lung cancer
    British Thoracic Society guidelines
    Thorax, October 2010, Vol 65. Supplement 3

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