• Stage 3A lung cancer is considered regional, having spread beyond the lung.
  • At stage 3A, there are several treatment options, including surgery, advanced drug therapies, chemotherapy, and radiation.
  • The outlook is affected by subtype of cancer, age, condition, genetics, and response to treatment.

In 2021, 235,760 people in the United States will receive a lung cancer diagnosis, according to the American Cancer Society. Diagnoses decline each year by about 2 percent.

Eighty-four percent of cases are non-small cell lung cancer (NSCLC). Those living with stage 3A NSCLC have more options for treatment now than ever before.

NSCLC is categorized by stages. The higher the number, the more advanced the cancer. Doctors use a system known as “TNM” to stage tumors:

  • T stands for the primary tumor and looks at whether it has grown into nearby structures.
  • N stands for regional lymph nodes and looks at whether cancer has spread to a nearby lymph node.
  • M stands for metastasis and looks at whether cancer has spread to other organs, such as the other lung, brain, bones, adrenal gland, or liver.

At stage 3A for NSCLC, there are several treatment options, including surgery, advanced drug therapies, chemotherapy, and radiation. People with stage 3A NSCLC may experience remission with treatment.

Doctors determine relative survival rates by comparing the life expectancy of people with a certain cancer diagnosis and stage with those who don’t have that cancer. The percentage is the relative likelihood of living past a certain amount of time, normally 5 years, as those not living with that cancer diagnosis.

The American Cancer Society uses the National Cancer Institute’s SEER database to assess relative survival rates. The SEER database divides cancer stage at the time of diagnosis by the extent of spread:

  • Localized. There is no cancer outside the lung.
  • Regional. Cancer has spread outside the lung to nearby areas or lymph nodes.
  • Distant. Cancer has spread to distant parts of the body.

Stage 3A NSCLC means the cancer has spread to the lymph nodes and may be present in nearby tissue and organs. Since the cancer has moved outside the lungs, the cancer is considered regional. The 5-year relative survival rate for regional NSCLC is 35 percent.

This statistic is based on those people given a diagnosis from 2009 to 2015. For this reason, survival rates are not predictive. Treatments are changing all the time. Outcomes could be different for people currently undergoing treatment.

The outlook for stage 3A NSCLC can be very different from person to person. Tumor size, the extent of spread to lymph nodes, and other spread vary within stage 3A.

For example, stage 3A NSCLC for people with two positive nodes has a 5-year survival rate of 10 to 15 percent. Cases where the spread is more extensive may have a lower overall survival rate.

There has been a long-term decline in deaths from lung cancer.

Stage 3A lung cancer means there has already been some spread, but there are options for treating the disease. Your survival rate can improve with treatment.

Your outlook can also be affected by:

  • the subtype of NSCLC
  • your age and condition
  • how your body responds to treatment
  • the genetic characteristics of your cells

Work with your doctor to decide on the best types of intervention.

The goal of treatment is to reduce the amount of cancer in the body. Medical interventions include removing or shrinking the tumors or strengthening the body’s immune system to target cancer cells.

These interventions can improve your outlook.

Doctors often recommend a combination of treatments for stage 3A lung cancer. These include:

  • surgery to remove cancerous tumors
  • radiation therapy to kill or shrink cancers before or after surgery
  • chemotherapy to shrink tumors before surgery or to remove undetectable cancer possibly left behind after surgery
  • immunotherapy to improve the immune system’s ability to fight off the cancer
  • targeted drug therapy using medications like osimertinib (Tagrisso) on cancer cells that have the EGFR gene or other therapies like bevacizumab (Avastin) to limit the growth factors released by tumors

Often, doctors start with chemotherapy and radiation. Then, they can surgically remove the tumors that remain. Some people may receive surgery as a first option. This depends on the size and location of the cancer, as well as overall health.

Stage 3A lung cancer can go into what is called “remission,” which means it has been controlled beyond the point of detection, or that its progression had been managed.

There are two types of remission:

  • Complete. Doctors can no longer detect tumors measured before treatment.
  • Partial. The tumor is at least 50 percent smaller after treatment and remains that small for at least 1 month.

Remission is typically the goal of cancer treatment. Doctors can’t always say for sure that the cancer is completely gone. Some cancer cells may remain after treatment, just below the level of detection.

Sometimes after the cancer has been undetected for some time, it comes back. This is called recurrence. If it has been less than a year since doctors were able to find cancer in the body, it may be called progression.

Cancer progression can mean that doctors thought they got all the cancer cells but missed some. It can also mean that some cancer cells resisted treatment and grew back.

There are three types of recurrence, depending on the location of the new cancer compared to the last cancer treated.

  • Local recurrence is lung cancer that reappears in the same place in the lungs.
  • Regional recurrence is lung cancer that appears in the lymph nodes near the original cancer site.
  • Distant recurrence is lung cancer that appears in a distant part of the body, like the brain.

A recurrence means doctors have found lung cancer cells in the new site, even if that site is not the lungs. If the new cancer is not made up of lung cancer cells, then doctors call it a second cancer and not a recurrence. The primary site of the second cancer in part determines treatment options and prognosis.

In stage 3B NSCLC, the cancer has spread to the lymph nodes on the same side as the primary cancer site and possibly the opposite side. The cancer has also spread to adjacent areas, like the chest wall, heart, breastbone, esophagus, trachea, or backbone.

At stage 3B, doctors treat the cancer with chemotherapy, radiation, laser therapy, and immunotherapy. Doctors may also recommend palliative treatment in addition to other treatments to increase comfort and quality of life.

While surgery is a treatment option for stage 3A NSCLC, it cannot remove all the cancer in stage 3B.

People with stage 3 NSCLC may also be interested in clinical trials for targeted therapy, treatments involving a radiosensitizer, or new radiation schedules.

Stage 3A lung cancer is treated with surgery, chemotherapy, radiation, new drugs to target cancer genes or behaviors, and immunotherapy. The outlook improves with treatment. Living with stage 3A lung cancer is a journey unique to each individual. By working with medical professionals, they can find the best course of therapies and support.