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Karen Ritter, RN BSN
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Important Facts About Stage 2 Lung Cancer
- Stage 2 of lung cancer has two sub-stages: 2A and 2B. Stage 2B is split into two additional sub-stages: 2B1 and 2B2. The main difference between 2A and 2B is whether cells have spread to the lymph nodes near the lungs.
- Stage 2 treatments include surgery, chemotherapy, immunotherapy and radiation.
- The 5-year survival rate for stage 2 lung cancer is above 50%.
- The main symptoms of stage 2 lung cancer are breathing issues, coughing, chest pain and a lower appetite.
What Is Stage 2 Lung Cancer?
Stage 2 lung cancer is one of the four stages of lung cancer that doctors diagnose after a biopsy or blood test. Non-small-cell lung cancer is the disease in 80% of lung cancer cases.
Stage 1 is the earliest possible diagnosis of non-small-cell lung cancer, and stage 4 is the most advanced type of cancer. Stage 2 is still considered an early diagnosis with a localized tumor.
Stage 2 lung cancer is split into two sub-stages: 2A and 2B. Stage 2A is defined by:
- A tumor 4-5 centimeters in diameter
- Cancer has not reached the nearby lymph nodes
- The lung cancer may have reached the main bronchus (airway from the windpipe to the lung) or spread to the innermost membrane layer around the lung
Stage 2B is the first stage where cells possibly reach the lymph nodes near the lungs. Stage 2B is divided into two additional sub-stages: 2B1 and 2B2.
Stage 2B1 is a tumor measuring 5 centimeters or smaller and the cancer has reached the lymph nodes on the same side of the chest as the primary tumor. Stage 2B2 has not reached the lymph nodes, but the main tumor is 5-7 centimeters. There also might be a secondary tumor on the lungs, plus cells in the:
- Pleura (lining of the lung cavity)
- Chest wall
- Nerves controlling the diaphragm
- Pericardium (lining around the heart)
What Are the Symptoms of Stage 2 Lung Cancer?
The most common symptoms of stage 2 lung cancer are issues with breathing. Respiratory system is affected since the tumor is big enough to affect how the lung tissue functions or how the lungs expand within the chest cavity.
The most likely symptoms in stage 2 lung cancer are:
- Shortness of breath
- Persistent cough
- Coughing up blood
- Loss of appetite
- Weight loss
- Mild chest pain
These symptoms are usually the same or similar for both stage 2A and 2B.
Stage 2 Lung Cancer Treatment
People with lung cancer need treatment to slow the growth of the cancer or even kill the disease. Stage 2 lung cancer is still localized and in the early stages to be treated with aggressive options such as surgery. Other treatment options include therapies such as chemotherapy or immunotherapy.
There are multiple types of surgery for lung cancer. Since stage 2 is more advanced than stage 1, a wedge resection might not remove enough lung tissue to get rid of the tumors. A wedge resection involves removing a wedge-shaped amount of tissue from the diseased lung.
The other surgeries for lung cancer are: pneumonectomy; lobectomy; and segmentectomy. A pneumonectomy removes the entire lung. This surgery will ensure the entire tumor and other exterior cells are gone, but it leaves the patient with only one lung. Some people are not healthy enough to live comfortably or for long with just one lung. It affects breathing.
Lobectomy is removal of one or two of the lung lobes. Each lung has multiple lobes. If the tumor is still in just one lobe – or two lobes on the right lung – then a lobectomy is possible. A segmentectomy is removal of a segment of the lobes. Each lobe has 2-5 segments. In stage 2, a segmentectomy is usually not aggressive enough to help the patient long-term.
Therapies for Stage 2 Lung Cancer
Stage 2 lung cancer can be treated with chemotherapy, immunotherapy or radiation therapy. Since the cancer is localized to the lung cavity, these therapies are best used before or after surgery.
Chemotherapy is usually given intravenously into the bloodstream. The intent is for chemotherapy to kill cancer cells but it also may injure healthy tissue.
Radiation therapy sends radiation beams into the lung cavity. The beams can burn and damage cancer cells but it may damage healthy tissue.
Immunotherapy is medication that helps the immune system fight cancer naturally. The U.S. Food and Drug Administration (FDA) has approved many immunotherapy drugs for lung cancer. The main ones are Opdivo (nivolumab), Imfinzi (durvalumab), Yervoy (ipilimumab) and Keytruda (pembrolizumab).
Immunotherapy is preferred by many patients and doctors because of fewer or less severe side effects compared to chemotherapy. Immunotherapy can cause discomfort but the drugs won’t harm healthy tissue. The therapies aim to block specific cancerous proteins that subdue the immune system. By blocking these proteins, the immune system kills lung cancer cells as they should.
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Life Expectancy for Stage 2 Lung Cancer
Life expectancy for lung cancer is measured by the 5-year survival rate. The 5-year rate for stage 2 lung cancer is near 60%. The rate is higher for stage 2A lung cancer. It’s around 65% for this sub-stage and around 55% for stage 2B.
Life expectancy is higher when patients have a successful surgery. If patients are not healthy enough for surgery, their chances of a long survival are lower. Immunotherapy can help, though. The 5-year survival rate for patients who get Keytruda and no other treatment is around 30%.
Frequently Asked Questions About Stage 2 Lung Cancer
What are the main symptoms of stage 2 lung cancer?
Stage 2 of lung cancer can cause shortness of breath, lower appetite, chest pain and unexplained weight loss. As the tumors get bigger, the lungs are not exchanging oxygen as well – causing shortness of breath and not able to expand as easily against the chest wall – causing chest pain.
What is the average survival for stage 2 lung cancer?
The average survival is around five years. In fact, the 5-year survival rate is above 50%. Most patients can get surgery, which helps them live for longer.
What is the surgery for stage 2 of lung cancer?
Doctors suggest surgery for patients with stage 2 lung cancer. Pneumonectomy (removing the entire lung) and lobectomy (removing a portion of the lung) are two surgeries used to remove lung cancer tumors and help improve the prognosis.
Can immunotherapy treat stage 2 lung cancer?
Immunotherapy can help with stage 2 lung cancer. Doctors usually prefer to give immunotherapy to patients either before or after surgery. The same is true for using chemotherapy.
Sources & Author
- Your Chances of Surviving Lung Cancer. WebMD. Retrieved from: https://www.webmd.com/lung-cancer/guide/lung-cancer-survival-rates. Accessed: 05/10/2022.
- 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.
- What Is Stage 2 Lung Cancer? Healthline. Retrieved from: . https://www.healthline.com/health/stage-2-lung-cancer. Accessed: 05/29/2022.
- Lung Cancer Survival Continues to Rise With Immunotherapy. Medpage Today. Retrieved from: https://www.medpagetoday.com/hematologyoncology/lungcancer/92329. Accessed: 07/19/2022.