Diagnosis often occurs at stage 3

Lung cancer is the leading cause of cancer death in the United States. It takes more lives than breast, prostate, and colon cancer combined, according to the Centers for Disease Control and Prevention.

In approximately 40 percent of people diagnosed with lung cancer, the disease has reached an advanced state at the time of diagnosis. One-third of those have reached stage 3.

According to the American Cancer Society, about 80 to 85 percent of lung cancers are non-small cell lung cancer (NSCLC). About 10 to 15 percent are small cell lung cancer (SCLC). These two types of lung cancer are treated differently.

While survival rates vary, stage 3 lung cancer is treatable. Many factors affect an individual’s outlook, including the stage of the cancer, treatment plan, and overall health.

Read more to learn about the symptoms, treatments, and outlook for stage 3 non-small cell lung cancer. This is the most common type of the disease.

When lung cancer reaches stage 3, it has spread from the lungs to other nearby tissue or distant lymph nodes. The broad category of stage 3 lung cancer is divided into two groups, stage 3A and stage 3B.

Both stage 3A and stage 3B are broken into subsections depending on tumor size, location, and lymph node involvement.

Stage 3A lung cancer: One side of the body

Stage 3A lung cancer is considered locally advanced. This means the cancer has spread to the lymph nodes on the same side of the chest as the primary lung tumor. But it has not traveled to distant areas in the body.

The main bronchus, lung lining, chest wall lining, chest wall, diaphragm, or membrane around the heart may be involved. There may be metastasis to the heart blood vessels, the trachea, the esophagus, the nerve governing the voice box, the chest bone or backbone, or the carina, which is the area where the trachea joins the bronchi.

Stage 3B lung cancer: Spread to the opposite side

Stage 3B lung cancer is more advanced. The disease has spread to lymph nodes above the collarbone or to the nodes on the opposite side of the chest from the site of the primary lung tumor.

Stage 3C lung cancer: Spread throughout chest

Stage 3C lung cancer has spread to all or part of the chest wall or its inner lining, the phrenic nerve, or the membranes of the sac that surrounds the heart.

Cancer has also reached stage 3C when two or more separate tumor nodules in the same lobe of a lung have spread to nearby lymph nodes. In stage 3C, the lung cancer has not spread to distant parts of the body.

Like stage 3A, stages 3B and 3C cancer may have spread to other chest structures. Part or all of the lung may become inflamed or collapse.

Early stage lung cancer may produce no visible symptoms. There may be noticeable symptoms, such as a new, persistent, lingering cough, or a change in a smoker’s cough (deeper, more frequent, produces more mucus or blood). These symptoms may indicate that the cancer has progressed to stage 3.

Other symptoms may include:

  • trouble breathing, being winded or short of breath
  • pain in chest area
  • wheezing sound when breathing
  • voice changes (hoarser)
  • unexplained drop in weight
  • bone pain (may be in the back and may feel worse at night)
  • headache

Treatment for stage 3 lung cancer typically begins with surgery to remove as much of the tumor as possible, followed by chemotherapy and radiation. Surgery alone is generally not indicated for stage 3B.

Your doctor may recommend radiation or chemotherapy as a first course of treatment if surgery is not possible to remove the tumor. Treatment with radiation and chemotherapy, either at the same time or sequentially, is associated with improved stage 3B survival rates compared with radiation-only treatment, according to the National Cancer Institute.

The five-year survival rate refers to the percentage of people who are alive five years after they’re first diagnosed. These survival rates can be divided by the stage of a particular cancer type at the time of diagnosis.

According to the American Cancer Society data derived from a database of people diagnosed with lung cancer between 1999 and 2010, the five-year survival rate for stage 3A NSCLC is about 36 percent. For stage 3B cancers the survival rate is about 26 percent. For stage 3C cancers the survival rate is about 1 percent.

It’s important to remember that stage 3 lung cancer is treatable. Everyone is different, and there is no precise way to predict how any individual will respond to treatment. Age and overall health are important factors in how well people respond to lung cancer treatment.

Talk with your doctor about any questions or concerns you may have about treatment. They will help you to explore the options available based on your stage, symptoms, and other lifestyle factors.

Lung cancer clinical trials may offer an opportunity to participate in an investigation of a new treatment. These new treatments may not offer a cure, but they have the potential to ease symptoms and extend life.

Q:

What are the benefits of quitting smoking, even after a stage 3 lung cancer diagnosis?

Anonymous patient

A:

According to a study in the British Medical Journal, quitting smoking after a diagnosis of early stage lung cancer improves outcomes. There’s evidence that suggests that continuing to smoke can interfere with the effects of treatment and increase side effects as well as increase your chances of cancer recurrence or a second cancer. It’s well-known that smoking cigarettes increases surgical complications, so if surgery is part of your treatment plan, smoking can lead to delays in systemic treatment. The bottom line is that it’s never too late to quit smoking. The benefits of quitting smoking are immediate and profound, even if you already have lung cancer. If you want to quit but are finding it difficult, ask your medical team for help.

Monica Bien, PA-CAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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