Stage 2B Lung Cancer: What You Should Know

Lung cancer is the second most common cancer is the world. It can occur in three different types of cells in the lungs:

• small cells
• neuroendocrine cells
• non-small cells

About 85 percent of lung cancers are non-small cell lung cancer (NSCLC).

The stages of NSCLC are:

• stage 0
• stage 1
• stage 2
• stage 3
• stage 4

Stage 2 represents a more advanced lung cancer compared to stage 0 and stage 1. Lung cancer that’s stage 2 is primarily in the lungs and may have also spread to lymph nodes. It’s less advanced than stage 3 and stage 4, and it hasn’t spread to distant lymph nodes or organs. The more advanced your lung cancer is, the less chance you have for curative treatment. Early detection is key.

Stage 2 NSCLC divides further into stage 2A and stage 2B. Typically, stage 2B is more advanced than stage 2A. The tumor in stage 2B is either larger or has spread to the nearby lymph nodes.

Approximately 225,000 people in the United States will be diagnosed with lung and bronchus cancer in 2016. Of these people, only some will have stage 2B lung cancer at diagnosis.

Typically, doctors use the size of the tumor, or T, the number of nodes involved, or N, and any distant disease sites, or M, to determine the cancer stage. You have stage 2B lung cancer if the cancer is “T2BN1M0,” which is defined by having at least one of the following features:

• The cancer has metastasized, or spread, to the lung or heart lining.
• The cancer tumor is between 5 and 7 centimeters (cm) in diameter.
• The cancer is at the main bronchus and is approximately 2 cm away from the carina of trachea.
• Airways are obstructed to the extent that the lung is partially collapsed or inflamed, but it doesn’t involve the entire lung.

In addition to one of these features, the cancer also needs to have spread to nearby lymph nodes on the same side of the lung for it to be classified as stage 2B.

You may also have stage 2B lung cancer if the cancer is “T3N0M0,” which indicates that it’s a larger tumor but the cancer isn’t found in the lymph nodes. One or more of the following define it:

• The tumor has spread to your diaphragm, nerves, chest wall, or other membranes in the lungs and airways.
• The tumor is greater than 7 cm in diameter.
• At least two separate tumors have emerged in the lobe of one lung.
• The cancer tumor has spread within 2 cm of the carina of trachea, but it doesn’t impact the carina of trachea.
• Airways are obstructed to the extent that the entire lung is collapsed or inflamed.

Symptoms of stage 2B lung cancer will be similar to the symptoms of all types of lung cancer. They may include:

• a progressive or persistent cough
• wheezing
• a poor appetite
• fatigue
• pain in the shoulder from Pancoast’s tumors
• chest pain
• difficulty swallowing and breathing
• excess weight loss
• swelling of the face and neck veins
• coughing up blood or mucus from the lungs

Delays in diagnosis and treatment can increase your chance of developing later stage lung cancer, like stage 2B. The following are additional risk factors for all lung cancer, including stage 2B:

• smoking
• being exposed to secondhand smoke
• being exposed to radon
• being exposed to other pollutants including arsenic, asbestos, and car exhaust
• having a family history of lung cancer
• having a poor diet
• having poor exercise habits
• having HIV

Lung cancer risk by race

Race is also a risk factor for lung cancer.

Lung cancer risk by sex

The risk of lung cancer is higher in men than it is in women.

Your doctor may suspect you have lung cancer based on your symptoms, their physical exam findings, and your lifestyle behaviors. Individual symptoms of lung cancer, such as worsening cough and chest pain, aren’t exclusive to lung cancer. If you’re experiencing some of these symptoms and are at high risk for lung cancer, you should see your doctor.

Your doctor may use findings from one or more of the following to make the diagnosis:

• a chest X-ray
• a physical exam
• a CT scan or a PET-CT scan, which involves the use of positron emission tomography
• a lung biopsy
• a mediastinoscopy
• a thoracoscopy
• a bronchoscopy

However, in most cases a tissue biopsy is necessary.

The treatment for stage 2B NSCLC may include:

• surgery
• chemotherapy
• radiation
• a combination of surgery, chemotherapy, and radiation

If you’re in good health and your doctor can safely remove your cancer, surgery is the recommended treatment. In many cases, doctors follow this with chemotherapy and possibly radiation. If you aren’t able to have surgery due to poor health or existing lung disease, your doctor will likely recommend a combination of chemotherapy and radiation as an alternative to surgery.

If surgery is a part of your treatment plan, it’s likely that your surgeon will remove the cancer through a lobectomy or sleeve resection. During a lobectomy, the surgeon will remove one of the lobes of your lungs. In certain instances, the doctor needs to remove the whole lung. This is known as a pneumonectomy.

Receiving treatment for stage 2B lung cancer can be difficult. In some cases, a better option might be to participate in clinical trials that are testing new drugs or therapies such as immunotherapy. Ask your doctor for more information about ongoing trials.

These medical interventions have been shown to treat stage 2B lung cancer successfully in some people. Maintaining a healthy lifestyle may increase your chances of successful treatment.

The five-year survival rate for stage 2B cancer is 31 percent. This means 31 percent of people who have stage 2B lung cancer will be living five years after diagnosis. This is only a general estimate. Your situation might be different based on the characteristics of the cancer and your treatment plan. Talk to your doctor to learn more. Constant communication is critical for a better outcome.

If you have stage 2B lung cancer your treatment will require a multidisciplinary approach. You can greatly improve your chances of successful treatment with proper planning and communication with your primary care doctor as well as with other members of the medical team, which may include:

• a thoracic surgeon
• a medical oncologist
• a radiation oncologist

The best approach to lung cancer is prevention. Not smoking tobacco is the best way to prevent lung cancer. Close to 90 percent of all lung cancer deaths may be attributable to smoking. The following behaviors may help lower your risk of developing lung cancer:

• Quit smoking if you smoke.
• Avoid secondhand smoke.
• Eat a healthy diet that includes vegetables and fruits.
• Do aerobic exercise regularly.
• Get your house tested for radon and other carcinogens.
• Make sure your work environment is free of carcinogens.

To prevent stage 1 or stage 2 cancer from progressing to stage 2B cancer, try the following:

• If you suspect tumor growth, go to a specialist for an evaluation.
• See an oncologist about proper treatments if your doctor diagnoses you with stage 1 or stage 2A lung cancer.
• Regularly communicate with your primary care doctor and oncologist about your treatment.

If you’re at high risk for lung cancer, talk to your doctor about other things you can do to reduce your risk or increase your chances for early detection.