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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 the lung cancer has 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 decreased 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 fluid or tissue biopsy. Non-small-cell is the type of lung cancer found in 80% of lung cancer cases.
Stage 1 is the earliest stage of non-small cell lung cancer, and stage 4 is the most extensive stage of cancer. Stage 2 is still considered an early diagnosis with a localized lung tumor.
Stage 2 lung cancer has two sub-stages: 2A and 2B.
Stage 2A is defined by:
- A tumor size of 4-5 centimeters in diameter
- Cancer has not spread to nearby lymph nodes
- The lung cancer may have spread to 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 of lung cancer where cells possibly have spread to lymph nodes within 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 spread to 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 close to the lung and that control 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. The 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.
Stage 2 lung cancer symptoms include:
- 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
Treatment options for stage 2 lung cancer are often needed to slow the growth of the cancer or shrink tumors. This stage lung cancer is typically still localized to the lung and early stage lung cancer can be treated with aggressive options such as surgery. Other treatment options include chemotherapy or immunotherapy.
There are multiple surgical options 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 affected lung.
The other surgeries for lung cancer include: pneumonectomy; lobectomy; and segmentectomy. A pneumonectomy removes the whole lung containing cancer. This surgery will ensure the entire tumor and other diseased lung tissue is removed, but it leaves the patient with one remaining lung. Some people who have stage 2 cancer may not be healthy enough to withstand this aggressive surgery or recover and live comfortably with only one lung.
Lobectomy is removal of one lobe of the lung. 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 for the cancer to be removed and help the patient long-term.
Other 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 tissue, 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 chest cavity. The beams can damage cancer cells but it also 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. They include Opdivo (nivolumab), Yervoy (ipilimumab), Keytruda (pembrolizumab) and Imfinzi (durvalumab).
Immunotherapy is preferred by many patients and doctors because of fewer or less severe side effects compared to chemotherapy. Immunotherapy may cause some side effects but the drugs do not harm healthy tissue cells. These unique therapies are used to block specific cancerous proteins that subdue the immune system. By blocking these proteins, the immune system kills any cancer cells that are identified.
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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 nearly 60%. The rate is higher for stage 2A lung cancer – around 65% for this sub-stage and around 55% for stage 2B.
Life expectancy is higher when patients are treated with surgery. If patients are not healthy enough for surgery, their chances of a long survival are lower. Treatment for lung cancer with immunotherapy can help. 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 lung cancer can cause shortness of breath, decreased 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 unable to function properly. The lungs may also not be able to expand as easily within 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%. In many cases, the cancer can be removed by surgery in this stage. This is likely the best kind of treatment to improve overall survival.
What is the surgery for stage 2 of lung cancer?
Doctors suggest surgery as part of the treatment plan 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 the cancer lung tumors and help improve the prognosis. Chemotherapy or immunotherapy may be given after surgery to help kill any remaining cancer cells.
Can immunotherapy treat stage 2 lung cancer?
Immunotherapy can be used as a treatment for stage 2 lung cancer. Cancer research has shown that giving immunotherapy or chemotherapy before or after surgery can improve overall outcomes. Immunotherapy can also be a stand alone therapy when surgery is not an option.
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.