I am a scientific researcher working on lung cancer. I am trying to develop a machine learning method able to process just few early detection features and then predict if a patient with lung cancer will develop metastasis (or not).

In my current statistical model, I am using the values of the following features as input:

  • T (tumor size) feature of the TNM staging system

  • N (presence of cancer in the lymph nodes) feature of the TNM staging system

  • age

From the values of these features related to a patient, my machine learning method should predict if he/she will have metastasis or not.

Before proceeding with this project, I need to know if my hypothesis is correct.

Two questions:

1) Can the T (tumor size) feature and the N (presence of cancer in the lymph node) feature be detected by doctors and their biomedical machines on the first visit?

2) My method would be useful in case the tumor size, presence of cancer in the lymph nodes, and age of a patient were available, when metastasis has not been detected (yet). Is this scenario realistic?

Thank you!

1 Answer 1


It is not likely that at the first visit, a doctor will even know if there is a cancer or not. One likely scenario is:

During the first visit, a doctor (a primary doctor or lung specialist) usually only asks about symptoms (chest pain, cough, coughing blood...) and checks for abnormal lung sounds, among other. At this visit, a doctor can order an X-ray, CT or MRI to check for eventual Tumor, its size and Nodes involvement, but this usually happens at another visit at a radiologist. At the third visit, the original doctor explains the results to the patient.

If lung cancer is suspected, a bronchoscopy with biopsy of the lesion is ordered, if applicable; this would be done at the 4th visit. The obtained sample needs to be checked by a pathologist, who sends the results to the original doctor, who explains them to the patient at the 5th visit.

It is the tumor size, type and location within the lungs, and node involvement that allows prognosis. Age by itself is not necessary a prognostic factor, but eventual comorbidities can be.

It is an experienced lung specialist or oncologist who can tell how realistic your scenario is. In any case, you would need to include more data than just T, N and age.

Further reading:

  • Thanks for this quick and very useful reply, it's pure gold! I now realize I should have use the words "first visits", instead of "first visit" in my question. 1st visit or 5th visit does not really matter for my project in fact; it's just important that it is early in the process. What I really would like to understand is: can tumor size and presence of cancer in the lymph node be detected earlier than metastasis? This aspect would be pivotal for my project. Also, since you seem to know a lot about this topic, do you how how lung cancer metastases are detected usually? Nov 27, 2018 at 17:42
  • Involvement of the local nodes (which usually means the ones within the chest) is called local metastases and the involvement of distant nodes and other organs distal metastases. Metastases can be confirmed by various imaging techniques (a CT, MRI with/out contrast or scintigraphy). Bronchoscopy can detect only the original tumor. The first imaging investigatiion can show tumor and, eventually, enlarged nodes in the chest, if they are present at the time. Distant metastases, even if present, will be likely missed at first imaging investigation, which usually involves only the chest.
    – Jan
    Nov 27, 2018 at 17:49
  • For different histological types of cancer there may be different substances ("tumor markers") in the blood that can be predictors of metastases, but they alone do not already prove them. You may want to check the sources I provided in my answer, especially this one.
    – Jan
    Nov 27, 2018 at 17:59
  • Thanks @Jan for your reply, it's been extremely useful! :-) Would you be interested in discussing further via email? We can collaborate on my project. My email address is davidechicco(AT)davidechicco.it Thanks! Nov 27, 2018 at 18:04
  • I only know what I have learned during studying medicine. I strongly recommend you to find an experienced pulmologist or oncologist and eventually visit him/her to make all this realistic.
    – Jan
    Nov 27, 2018 at 18:09

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