Spread through air spaces, often abbreviated as STAS, is a term pathologists use to describe how lung cancer cells can invade nearby healthy lung tissue. In this pattern, cancer cells move away from the main tumour and spread into the tiny air-filled spaces within the lungs. STAS is most commonly seen in a type of lung cancer called adenocarcinoma.
Why is spread through air spaces important?
Finding STAS in lung cancer is important because it has been linked with a higher chance of the cancer coming back after treatment (recurrence) and a poorer overall prognosis. This is especially true in early-stage lung cancers. Identifying STAS can help doctors understand how aggressive the cancer might be, assisting them in determining the most effective treatment and follow-up plan.
How do pathologists identify spread through air spaces?
Pathologists identify STAS by closely examining samples of lung tissue under a microscope. They look specifically at the lung tissue surrounding the main tumour, searching for individual cancer cells or small clusters of cancer cells floating freely in the air spaces or attached to their walls. Importantly, these cells must be clearly separate from the main tumour mass, rather than simply at the tumour’s edge. Pathologists also ensure these cells are not due to other factors, such as tissue processing errors (artefacts) or cancer cells travelling through blood or lymphatic vessels (lymphovascular invasion).
How does STAS affect my treatment?
If STAS is identified in your lung cancer sample, your doctor might recommend more aggressive or comprehensive treatments. Depending on your individual circumstances, this could include a combination of surgery, chemotherapy, radiation, or targeted therapies. Recognising STAS helps your medical team develop a personalised treatment approach to better manage your cancer and reduce the risk of recurrence.
Questions to ask your doctor
If your pathology report mentions STAS, you might consider asking:
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What does the presence of STAS mean for my overall prognosis?
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Will STAS affect the type of treatments I receive?
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Do I need additional tests or scans based on this finding?
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How will we monitor for potential recurrence?
Understanding the significance of spread through air spaces (STAS) can help you actively participate in decisions about your cancer care.
