How is lung cancer diagnosed?
Pulmonary specialists at Penn Medicine evaluate and diagnose patients with signs of lung cancer. Your provider will do a physical exam, review your medical history, check you for general signs of health, and ask about your health habits, past jobs, illnesses, and treatments. Your provider will likely also recommend diagnostic imaging tests and procedures.
Classifying and staging lung cancer
Lung cancer staging is the process of finding out if cancer is present and how far it has spread. Non-small cell lung cancer and small cell lung cancer are staged differently.
Our doctors use the TNM system to stage non-small cell lung cancer. The TNM staging system is one of the most widely used cancer-staging systems worldwide. It describes:
- Tumor (T): The size and other characteristics of the main tumor, called the primary tumor.
- Node (N): The number of lymph nodes affected by cancer cells.
- Metastasis (M): If the cancer has spread to other parts of the body.
These details help to classify the cancer into one of the following stages:
- Stage I: The cancer is in the lungs and has not spread.
- Stage II: The cancer is in the lungs and has started to spread to nearby lymph nodes.
- Stage III (locally advanced disease): The cancer is in the lungs and lymph nodes in the chest. Stage III has two subtypes:
- Stage IIIA: The cancer has spread to lymph nodes on the same side of the chest as the primary tumor.
- Stage IIIB: The cancer has spread to lymph nodes on the other side of the chest or by the collarbone.
- Stage IV (advanced disease): The cancer is in both lungs or has spread to fluid around the lungs or other parts of the body, such as the liver, bones, or brain.
The small cell lung cancer stages are broken up into two categories:
- Limited-stage small cell lung cancer: The cancer is in the lung and may have spread to an area between the lungs called the mediastinum or to lymph nodes near the collarbone.
- Extensive-stage small cell lung cancer: The cancer has spread to other areas in the body.
How Penn Medicine determines your lung cancer stage
To determine the cancer stage, our experts perform a physical exam, biopsies, and imaging tests. During the biopsy, a sample of the tumor tissue is taken so our doctors who specialize in lung cancer diagnosis, called pulmonary pathologists, can perform genetic tests on the cancer cells. Traditional biopsy results generally come back within two to six weeks.
In some small cell lung cancer cases, we also offer liquid biopsy. Liquid biopsy is a groundbreaking blood test we developed that can identify tumor targets within a week. This means you may be able to get targeted therapy to treat lung cancer more quickly. Targeted therapy involves highly effective medication you take at home. There are a variety of other lung cancer treatment options available at Penn Medicine.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.