Staging
Staging is the process of determining how much cancer there is in the body and where it is located. Staging of lung cancer is of paramount importance as treatment choices are often highly complex, even for physicians with much experience in the field, and the options largely depend on the stage of the disease. The underlying purpose is to describe the extent or severity of an individual's cancer, and to bring together cancers that have similar prognosis and treatment.
Staging information which is obtained prior to surgery, for example by x-rays and endoscopic ultrasound, is called clinical staging and staging by surgery is known as pathological staging.
Clinical staging is done by a combination of imaging and sampling (biopsies), or stated differently, non-invasive (radiological) and invasive (biopsy) methods.
Pathologic staging is more accurate than clinical staging, but clinical staging is the first and sometimes the only staging type. For example, if clinical staging reveals stage IIIB or IV disease, surgery is not helpful and no pathological staging information will be obtained (appropriately).
Lung cancer biopsies can be taken for two different reasons:
- Diagnosis: To find out whether an abnormality seen on a chest x-ray or CT scan is indeed lung cancer, and what histological type it is (small cell or non-small cell).
- Staging: To find out whether a structure, such as a lymph node in the mediastinum, has already been invaded by cancer or not.
However, it is often possible, with proper planning, to obtain both diagnostic and staging information with a single biopsy procedure.
There is an extensive array of staging methods available, each with advantages and disadvantages. Many cancer treatment centers review newly diagnosed patients at an inter-disciplinary chest tumor board where radiologists, oncologists, surgeons, pulmonologists, pathologists and EUS specialists (endosonographers) discuss the relative merits of the available modalities and make a choice by consensus.
Read more about this topic: Lung Cancer Staging
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