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"Localized" Lung Cancer

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The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013

Question

My father-in-law has small cell lung cancer. When I asked the oncologist what stage it was, he told me it is localized. I am not sure what that means. Could you explain what a localized cancer is and what stage it is?

Answer

Anil Vachani, MD, Pulmonologist at Penn Medicine, responds:

Small cell lung cancer is staged differently than most other solid tumors. Disease is classified as either limited or extensive. Limited disease is confined to one side of the lung (right or left) and to regional lymph nodes, which is what it sounds like your father-in-law has. With limited-stage disease, all of the cancer can be incorporated within a single radiation therapy portal, making radiation therapy a good treatment for these patients and potentially curative. Extensive disease refers to the situation where there is obvious spread of the cancer outside of the chest. The disease stage is important because it helps determine prognosis and identifies patients who can be potentially treated with radiation therapy (those with limited stage).

Non-small cell lung cancer is staged using the AJCC Staging System and is treated differently. Patients are classified into one of four stages (I-IV), with Stage I being the most localized (or confined to one area), while Stage IV indicates distant spread of the disease to other organs (this is the equivalent of extensive-stage disease for small cell lung cancer). Early-stage or localized disease (Stage I or II) is usually treated with surgery. These patients may also benefit from adjuvant chemotherapy (chemotherapy after the surgery). Unfortunately, only 15-20% of patients with non-small cell lung cancer are diagnosed with early-stage disease; the remainder have more extensive disease (Stage III or IV) and a poorer prognosis.