Written by: Devin Golden

Stages of Asbestos Lung Cancer

The lung cancer stages are ways to classify the size of lung cancer. If you or a family member has lung cancer, you’ll want to know details about each stage of lung cancer. There is no difference in stages of asbestos lung cancer and non-asbestos lung cancer.

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Important Facts About Stages of Lung Cancer

  • There are four stages of non-small-cell lung cancer and two stages of small-cell lung cancer.
  • Most of the non-small-cell lung cancer stages have sub-stages to differentiate based on tumor size.
  • The treatment for lung cancer and lung cancer survival rates change based on which stage you are in.

What Are the Stages of Lung Cancer?

Lung cancer is usually separated into four stages: stage 1, stage 2, stage 3 and stage 4. Stage 1 is the earliest form of lung cancer. Stage 4 is the most advanced. This system is for non-small-cell lung cancer (NSCLC).

NSCLC stages are split into subgroups. These subtypes – such as stage 3A and stage 3B – provide more specifics on size of the lung tumor and how far it has spread.

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Stage 1 Lung Cancer

Stage 1 lung cancer has two subtypes. It is split into 1A lung cancer and 1B lung cancer. Most, if not all, surgeries and other treatment options are available in these stages. Stage 1 lung cancer has a 5-year survival rate of around 80%.

Stage 1A Lung Cancer

Stage 1A lung cancer is the earliest official stage of non-small-cell lung cancer. The tumor is restricted to just the lung. It’s only 3 centimeters or smaller in diameter.

The 5-year survival rate for stage 1A lung cancer is approximately 85%. Surgery can improve this already-excellent rate.

Patients in stage 1A lung cancer usually have every surgery as an option. Segmentectomy and lobectomy are less-extensive surgeries than completely removing the lung (pneumonectomy):

  • Lobectomy removes one or two lobes of the cancerous lung.
  • Segmentectomy removes sections of a lobe instead of an entire lobe.

Stage 1B Lung Cancer

Stage 1B lung cancer is a slightly larger tumor than stage 1A. The cancer also may have spread a little beyond the lung.

Stage 1B tumors are between 3 centimeters and 4 centimeters. The tumor has not spread to the nearby lymph nodes but may have reached one of the following:

  • The main bronchus, which is an airway from the windpipe to the lung
  • Innermost layer of the membrane covering the lung

Stage 1B lung cancer is the first stage where part of the lung or whole lung may have collapsed or developed pneumonitis. All stages after 1B may also have a collapsed lung or pneumonitis.

Stage 1B lung cancer has a 5-year survival rate of 73%. All types of lung cancer surgery are options for patients.

Stage 2 Lung Cancer

Stage 2 lung cancer is similar to stage 1. Stage 2 is split into two subtypes: stage 2A and stage 2B. Most treatment options are available to patients. Stage 2 lung cancer has a 5-year survival rate of around 60%.

Stage 2A Lung Cancer

Stage 2A lung cancer is a tumor between 4 centimeters and 5 centimeters in diameter. Cancer has not reached the nearby lymph nodes but one of the following may occur:

  • Cancer reached the main bronchus, the airway from the windpipe to the lung
  • Cancer has spread to the innermost layer of the membrane around the lung

Stage 2A lung cancer’s 5-year survival rate is 65%. Each surgery for lung cancer is an option, although doctors may prefer a lobectomy or pneumonectomy to make sure all tumors and cells are removed.

Stage 2B Lung Cancer

Stage 2B lung cancer has two versions: stage 2B1 and stage 2B2. Lung cancer in stage 2B is the first stage where cells may have reached nearby lymph nodes.

The first form of stage 2B lung cancer tumors are 5 centimeters or smaller. The cancer has reached the lymph nodes on the same side of the chest as the tumor. These lymph nodes are either in the lung or near the bronchus.

The other description of this stage is a tumor between 5 centimeters and 7 centimeters. Cancer cells have not reached the lymph nodes. Stage 2B2 may have at least one extra in the same lobe as the primary tumor, plus cancer in the:

  • Membrane lining the chest wall (pleura)
  • Chest wall
  • Nerve controlling the diaphragm
  • Outer tissue layer in the sac around the heart (pericardium)

Stage 2B lung cancer has a 56% 5-year survival rate. Doctors often prefer a pneumonectomy or lobectomy if patients are eligible for surgery.

Stage 3 Lung Cancer

Stage 3 lung cancer is split into three subtypes: stage 3A, stage 3B and stage 3C. This is the only of the four stages with three subtypes. Some treatment options, such as surgery, might not be available to patients. These are often decided on a case-by-case basis in stage 3 lung cancer.

Stage 3A lung cancer’s 5-year survival rate is around 25%.

Stage 3A Lung Cancer

Stage 3A lung cancer has three different descriptions of tumor size and cancer spread.

The first description of stage 3A lung cancer is a tumor 5 centimeters or smaller in diameter and cells in the lymph nodes. The impacted lymph nodes are around your trachea (windpipe) or aorta (main artery carrying blood from the heart to the rest of your body). Impacted lymph nodes may be where the trachea branches off into separate bronchi (airways from the lung to the trachea).

The second form of stage 3A lung cancer is a tumor between 5 centimeters and 7 centimeters and cells have reached nearby lymph nodes. One of the following may also have happened:

  • At least one extra tumor on the same lobe as the main tumor
  • Cancer reaching the membrane lining the chest wall (pleura), the chest wall, the nerve controlling the diaphragm, or the outer tissue of the sac around the heart (pericardium)

The third description is a tumor larger than 7 centimeters and lymph node activity on the same side of the chest as the main tumor. The cancer may have expanded to multiple tumors in the same lobe of the lung and spread to the:

  • Trachea (windpipe)
  • Esophagus
  • Breastbone
  • Backbone
  • Diaphragm
  • Heart
  • Blood vessels connected to the heart
  • Nerve controlling the larynx (voice box)

The 5-year survival rate for 3A lung cancer is 41%. This is the first stage where many patients aren’t eligible for surgery. Some may have a pneumonectomy along with chemotherapy or immunotherapy.

Stage 3B Lung Cancer

Stage 3B lung cancer has two descriptions to help doctors diagnose this stage.

The first is mostly defined by spread to distant lymph nodes. The tumor is 5 centimeters in diameter or smaller. Lymph nodes affected are above the collarbone on the same side of the chest as the tumor. Cancer may also have spread to the:

  • Bronchus (airway connecting the windpipe and lung)
  • Innermost layer of membrane covering the lung

The other description usually involves a bigger tumor. The tumor can be any size, and cells have spread to lymph nodes on the same side of the chest as the main tumor. The affected lymph nodes are around the trachea (windpipe) or aorta (main blood vessel of the heart).

There may also be one or more separate tumors in the lung, and cancer might have reached the:

  • Membrane lining the chest wall (pleura)
  • Chest wall
  • Nerve controlling the diaphragm
  • Outer lining around the heart (pericardium)
  • Trachea
  • Esophagus
  • Breastbone
  • Backbone
  • Diaphragm
  • Heart
  • Major blood vessels
  • Nerve controlling the larynx (voice box)

The 5-year survival rate for 3B lung cancer is 24%. Most cases of stage 3B lung cancer are not eligible for surgery. The cancer is too advanced and has spread too far beyond the lungs for this treatment.

Stage 3C Lung Cancer

Stage 3C only has one description, unlike the other subtypes of stage 3 lung cancer. Stage 3C is a tumor of any size. Cancer has spread to distant lymph nodes, specifically those:

  • Above the collarbone on the same side of the chest of the affected lung
  • On the other side of the chest from the main tumor

There are also multiple tumors in the lung for stage 3C. Cancer cells have spread to at least one of the:

  • Membrane lining the chest wall (pleura)
  • Chest wall
  • Nerve controlling the diaphragm
  • Outer lining around the heart (pericardium)
  • Trachea
  • Esophagus
  • Breastbone
  • Backbone
  • Diaphragm
  • Heart
  • Major blood vessels
  • Nerve controlling the larynx (voice box)

Stage 3C lung cancer has a 12% 5-year survival rate. Cancer in this stage is usually too advanced for surgery. Chemotherapy, immunotherapy and radiation are the treatment options doctors use first in stage 3C.

Stage 4 Lung Cancer

Stage 4 lung cancer has two subtypes: stage 4A and stage 4B. This is the most advanced form of lung cancer. Treatment options are limited to palliative therapy, which can be low-dose chemotherapy and radiation therapy. Clinical trials are another option for stage 4 lung cancer.

Stage 4 lung cancer’s 5-year survival rate is less than 10%.

Stage 4A Lung Cancer

Stage 4A is a tumor of any size and cells reaching lymph nodes. This stage is often defined by cells found in distant areas. There may be:

  • Multiple tumors in the lung aside from the main tumor
  • Cancer found in the lining of the lung (pleura) or sac around the heart (pericardium)
  • Cancer in the fluid around the lungs or heart
  • Cancer reaching an organ not near the lung, such as the brain, liver, kidney or bone

Only 10% of people in stage 4A lung cancer live for five years. Surgery is almost never an option for stage 4A lung cancer. Treatment focuses on palliative care and reducing pain from symptoms.

Stage 4B Lung Cancer

Stage 4B lung cancer is one of the simplest stages to describe. This is the most advanced stage of lung cancer. It is when cancer has spread to multiple places in at least one organ aside from the lung. This organ could be the brain, liver or kidney.

The reported 5-year survival rate for stage 4B lung cancer is close to 0%. Surgery is not an option in stage 4B lung cancer. Palliative treatment is used to reduce pain from symptoms.

Other Stages of Non-Small-Cell Lung Cancer

Two other stages of NSCLC are occult stage and stage 0. Occult stage means the tumor or cancerous cells are hidden from imaging tests or diagnostic surgery. Occult stage is usually an early or dormant form of lung cancer. This means the survival rates are likely better than other stages.

Stage 0 means there are mutated cells found in the airways. These cells aren’t cancerous yet and haven’t formed a tumor on the lungs. Doctors usually monitor the cells and don’t begin treatment.

There are two types of stage 0 lung cancer: adenocarcinoma in situ and squamous cell carcinoma in situ. Stage 0 usually has better survival rates as well.

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Stages of Small-Cell Lung Cancer

Small-cell lung cancer (SCLC) has just two stages: limited-stage lung cancer and extensive-stage lung cancer. Limited-stage lung cancer is the earlier stage and has a better life expectancy than extensive-stage lung cancer.

Limited-stage Lung Cancer

In limited-stage cancer, the tumor is still just in the lung. This is where lung cancer begins. Limited-stage lung cancer may have spread to the space between the lungs (called the mediastinum). Limited-stage lung cancer can also involve cells in the lymph nodes above the collarbone.

The 5-year survival rate for limited-stage small-cell lung cancer is 30-35%. Surgery is an option for some patients, although SCLC has smaller cells that are less noticeable and easily spread to lymph nodes. This makes surgery challenging. According to the American Cancer Society, most patients have chemotherapy and radiation concurrently (called chemoradiation).

Extensive-Stage Lung Cancer

Extensive-stage lung cancer means the tumor has spread beyond the lungs or lung cavity. Cells often appear in distant areas of the body, such as the spinal cord or brain.

Surgery is not an option for extensive-stage lung cancer. Radiation also is rarely used. Most patients in this stage receive chemotherapy or an immunotherapy treatment. Chemotherapy can cause tumors to shrink, but the average survival is around one year with treatment.

Sources & Author

    1. Your Chances of Surviving Lung Cancer. WebMD. Retrieved from: https://www.webmd.com/lung-cancer/guide/lung-cancer-survival-rates. Accessed: 05/10/2022.
    2. Non-Small Cell Lung Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute. Retrieved from: https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq. Accessed: 05/04/2022.
    3. Small Cell Lung Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute. Retrieved from: https://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq. Accessed: 05/04/2022.
    4. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. The Lancet. Retrieved from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02333-3/fulltext. Accessed: 05/04/2022.
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About the Writer, Devin Golden

Devin Golden is the content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.