Table of ContentsView AllTable of ContentsClassificationsSymptomsDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Classifications
Symptoms
Diagnosis
Treatment
Prognosis
Lung canceroften spreads to thelymph nodesbefore spreading to other parts of the body. Which groups of lymph nodes are involved, and where these are in relation to theprimary (original) tumor, are important factors in determining the stage of cancer and how it should be treated.
This article discusses the spread of lung cancer to the lymph nodes and what this means for treatment and prognosis.
Verywell / Cindy Chung
Lymph Node Metastases
Lymph nodes often serve as the “firewalls” for cancer as cells are shed from the primary tumor. Cancer in the lymph nodes does not necessarily mean your cancer is late-stage. However, the presence of cancer in lymph nodes tells your healthcare provider that the tumor intends to spread and that more aggressive treatment may be needed to reduce the risk ofrecurrence.
If the lung cancer has spread beyond regional lymph nodes and is found in distant lymph nodes or other tissues, the disease is consideredmetastatic.
How Fast Does Lung Cancer Spread?
Regional Lymph Node Classifications
For the purpose of staging, regional lymph nodes are divided into three groups:
You will often not have any specific symptoms indicating that cancer has spread to your lymph nodes. If you do, they may include:
Beyond that, any symptoms you have may be related to lung cancer in general. Early signs may include:
Signs and Symptoms of Lung Cancer
After lung cancer is diagnosed, your physician will order tests to see if your tumor has spread to lymph nodes or distant sites.
Common diagnostic tests include:
How Lung Cancer Is Diagnosed
Staging
Can Lung Cancer Be Detected Through Blood Tests?
The treatment for lung cancer that has spread to lymph nodes depends upon the stage of cancer and your general health.
SLND is typically used for N1 disease but can also be used as a preventive measure in people with N0 disease.
Prior to the SLND procedure, a PET scan will be performed with or without an accompanyingCT scan with contrast. This helps the surgeon pinpoint which lymph nodes are affected. The surgeon can then decide which to remove based on the pattern of lymph node drainage. To be safe, the surgeon will usually remove several unaffected lymph nodes just beyond the boundary of the affected ones.
SLND typically requires a two- to three-day hospital stay. Bleeding and pain are common after the surgery, but infection is rare.
After the lymph nodes are removed,radiation therapymay be used to kill any remaining cells and prevent a recurrence.
Additional lung cancer therapies may also be prescribed based on the stage of cancer. These include:
SLND is rarely if ever used when there are numerous affected lymph nodes. In such cases, standard therapies will be pursued.
With that said, a 2016 study in theJournal of Thoracic Diseasesdescribed certain characteristics of lung cancer in the lymph nodes that may indicate better or poorer outcomes:
Lung Cancer Stages, Prognosis, and Progression
Five-Year Survival
Small-Cell Lung CancerAll stages: 6%Localized: 29%Regional: 15%Distant: 3%Non-Small Cell Lung CancerAll stages: 23%Localized: 60%Regional: 33%Distant: 6%
Small-Cell Lung CancerAll stages: 6%Localized: 29%Regional: 15%Distant: 3%
All stages: 6%
Localized: 29%
Regional: 15%
Distant: 3%
Non-Small Cell Lung CancerAll stages: 23%Localized: 60%Regional: 33%Distant: 6%
All stages: 23%
Localized: 60%
Regional: 33%
Distant: 6%
Summary
Your lung cancer will be staged depending on whether the cancer has spread to the lymph nodes and which lymph nodes are involved. Your treatment will be based on the extent of the spread. Treatment may be surgical or you may receive chemotherapy and/or other therapies.
A Word From Verywell
It is important to become part of this process as a partner in your own care. If there is something you don’t understand, let the doctor know. By understanding as much as you can about your diagnosis and treatment, you can make more informed choices and feel more in control of your condition.
If, on the other hand, you are not getting the information you need to make an informed choice, do not hesitate to seek asecond opinionfrom a qualifiedoncologist.
Coping and Living Well With Lung Cancer
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Popper HH.Progression and metastasis of lung cancer.Cancer Metastasis Rev. 2016;35(1):75-91. doi:10.1007/s10555-016-9618-0Cancer Research UK.Lung cancer.Xia Y, Zhang B, Zhang H, Li W, Wang KP, Shen H.Evaluation of lymph node metastasis in lung cancer: who is the chief justice?.J Thorac Dis. 2015;7(Suppl 4):S231-7. doi:10.3978/j.issn.2072-1439.2015.11.63Feng SH, Yang ST.The new 8th TNM staging system of lung cancer and its potential imaging interpretation pitfalls and limitations with CT image demonstrations.Diagn Interv Radiol.2019;25(4):270-9. doi:10.5152/dir.2019.18458National Cancer Institute. SEER Training Modules.Lymph node involvement.Datta, A, Madhumita, R.Cancer genetics and therapeutics: focus on phytochemicals. Singapore: Springer.Siddiqui F, Siddiqui AH.Cancer, lung. In: StatPearls.Society of Nuclear Medicine & Molecular Imaging. Value Initiative.Lung cancer.Brierley J, Gospodarowicz M, O’Sullivan B.The principles of cancer staging.Ecancer Med Sci.2016;10:ed61. doi:10.3332/ecancer.2016.ed61Rami-Porta R, Asamura H, Travis WD, Rusch VW.Lung cancer - major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.CA Cancer J Clin. 2017;67(2):138-155. doi:10.3322/caac.21390Han H, Chen H.Selective lymph node dissection in early-stage non-small cell lung cancer.J Thorac Dis.2017;9(7):2102-7. doi:10.21037/jtd.2017.06.04Paleri V, Urbano TG, Mehanna H, et al.Management of neck metastases in head and neck cancer: United Kingdom national multidisciplinary guidelines.J Laryngol Otol. 2016 May; 130(Suppl 2): S16 1-9.doi:10.1017/S002221511600058XRena O.The “N”-factor in non-small cell lung cancer: staging system and institutional reports.J Thorac Dis.2016;8(11):3049-52. doi:10.21037/jtd.2016.11.37National Cancer Institute Surveillance, Epidemiology, and End Results Program.Cancer Stat Facts: Lung and Bronchus Cancer.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Popper HH.Progression and metastasis of lung cancer.Cancer Metastasis Rev. 2016;35(1):75-91. doi:10.1007/s10555-016-9618-0Cancer Research UK.Lung cancer.Xia Y, Zhang B, Zhang H, Li W, Wang KP, Shen H.Evaluation of lymph node metastasis in lung cancer: who is the chief justice?.J Thorac Dis. 2015;7(Suppl 4):S231-7. doi:10.3978/j.issn.2072-1439.2015.11.63Feng SH, Yang ST.The new 8th TNM staging system of lung cancer and its potential imaging interpretation pitfalls and limitations with CT image demonstrations.Diagn Interv Radiol.2019;25(4):270-9. doi:10.5152/dir.2019.18458National Cancer Institute. SEER Training Modules.Lymph node involvement.Datta, A, Madhumita, R.Cancer genetics and therapeutics: focus on phytochemicals. Singapore: Springer.Siddiqui F, Siddiqui AH.Cancer, lung. In: StatPearls.Society of Nuclear Medicine & Molecular Imaging. Value Initiative.Lung cancer.Brierley J, Gospodarowicz M, O’Sullivan B.The principles of cancer staging.Ecancer Med Sci.2016;10:ed61. doi:10.3332/ecancer.2016.ed61Rami-Porta R, Asamura H, Travis WD, Rusch VW.Lung cancer - major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.CA Cancer J Clin. 2017;67(2):138-155. doi:10.3322/caac.21390Han H, Chen H.Selective lymph node dissection in early-stage non-small cell lung cancer.J Thorac Dis.2017;9(7):2102-7. doi:10.21037/jtd.2017.06.04Paleri V, Urbano TG, Mehanna H, et al.Management of neck metastases in head and neck cancer: United Kingdom national multidisciplinary guidelines.J Laryngol Otol. 2016 May; 130(Suppl 2): S16 1-9.doi:10.1017/S002221511600058XRena O.The “N”-factor in non-small cell lung cancer: staging system and institutional reports.J Thorac Dis.2016;8(11):3049-52. doi:10.21037/jtd.2016.11.37National Cancer Institute Surveillance, Epidemiology, and End Results Program.Cancer Stat Facts: Lung and Bronchus Cancer.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Popper HH.Progression and metastasis of lung cancer.Cancer Metastasis Rev. 2016;35(1):75-91. doi:10.1007/s10555-016-9618-0Cancer Research UK.Lung cancer.Xia Y, Zhang B, Zhang H, Li W, Wang KP, Shen H.Evaluation of lymph node metastasis in lung cancer: who is the chief justice?.J Thorac Dis. 2015;7(Suppl 4):S231-7. doi:10.3978/j.issn.2072-1439.2015.11.63Feng SH, Yang ST.The new 8th TNM staging system of lung cancer and its potential imaging interpretation pitfalls and limitations with CT image demonstrations.Diagn Interv Radiol.2019;25(4):270-9. doi:10.5152/dir.2019.18458National Cancer Institute. SEER Training Modules.Lymph node involvement.Datta, A, Madhumita, R.Cancer genetics and therapeutics: focus on phytochemicals. Singapore: Springer.Siddiqui F, Siddiqui AH.Cancer, lung. In: StatPearls.Society of Nuclear Medicine & Molecular Imaging. Value Initiative.Lung cancer.Brierley J, Gospodarowicz M, O’Sullivan B.The principles of cancer staging.Ecancer Med Sci.2016;10:ed61. doi:10.3332/ecancer.2016.ed61Rami-Porta R, Asamura H, Travis WD, Rusch VW.Lung cancer - major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.CA Cancer J Clin. 2017;67(2):138-155. doi:10.3322/caac.21390Han H, Chen H.Selective lymph node dissection in early-stage non-small cell lung cancer.J Thorac Dis.2017;9(7):2102-7. doi:10.21037/jtd.2017.06.04Paleri V, Urbano TG, Mehanna H, et al.Management of neck metastases in head and neck cancer: United Kingdom national multidisciplinary guidelines.J Laryngol Otol. 2016 May; 130(Suppl 2): S16 1-9.doi:10.1017/S002221511600058XRena O.The “N”-factor in non-small cell lung cancer: staging system and institutional reports.J Thorac Dis.2016;8(11):3049-52. doi:10.21037/jtd.2016.11.37National Cancer Institute Surveillance, Epidemiology, and End Results Program.Cancer Stat Facts: Lung and Bronchus Cancer.
Popper HH.Progression and metastasis of lung cancer.Cancer Metastasis Rev. 2016;35(1):75-91. doi:10.1007/s10555-016-9618-0
Cancer Research UK.Lung cancer.
Xia Y, Zhang B, Zhang H, Li W, Wang KP, Shen H.Evaluation of lymph node metastasis in lung cancer: who is the chief justice?.J Thorac Dis. 2015;7(Suppl 4):S231-7. doi:10.3978/j.issn.2072-1439.2015.11.63
Feng SH, Yang ST.The new 8th TNM staging system of lung cancer and its potential imaging interpretation pitfalls and limitations with CT image demonstrations.Diagn Interv Radiol.2019;25(4):270-9. doi:10.5152/dir.2019.18458
National Cancer Institute. SEER Training Modules.Lymph node involvement.
Datta, A, Madhumita, R.Cancer genetics and therapeutics: focus on phytochemicals. Singapore: Springer.
Siddiqui F, Siddiqui AH.Cancer, lung. In: StatPearls.
Society of Nuclear Medicine & Molecular Imaging. Value Initiative.Lung cancer.
Brierley J, Gospodarowicz M, O’Sullivan B.The principles of cancer staging.Ecancer Med Sci.2016;10:ed61. doi:10.3332/ecancer.2016.ed61
Rami-Porta R, Asamura H, Travis WD, Rusch VW.Lung cancer - major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.CA Cancer J Clin. 2017;67(2):138-155. doi:10.3322/caac.21390
Han H, Chen H.Selective lymph node dissection in early-stage non-small cell lung cancer.J Thorac Dis.2017;9(7):2102-7. doi:10.21037/jtd.2017.06.04
Paleri V, Urbano TG, Mehanna H, et al.Management of neck metastases in head and neck cancer: United Kingdom national multidisciplinary guidelines.J Laryngol Otol. 2016 May; 130(Suppl 2): S16 1-9.doi:10.1017/S002221511600058X
Rena O.The “N”-factor in non-small cell lung cancer: staging system and institutional reports.J Thorac Dis.2016;8(11):3049-52. doi:10.21037/jtd.2016.11.37
National Cancer Institute Surveillance, Epidemiology, and End Results Program.Cancer Stat Facts: Lung and Bronchus Cancer.
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