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Karen Ritter, RN BSN
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Important Facts About Stage 3 Lung Cancer
- Stage 3 is the turning point of advanced lung cancer, meaning the cancer can still be contained to one lung or the cancer may have spread to other parts of the body.
- The standard treatment for stage 3 lung cancer is chemotherapy and radiation.
- Stage 3 lung cancer has three subcategories: 3A, 3B and 3C, all with important differences.
- The average survival time for stage 3 lung cancer is dependent on the designated subcategory.
What Is Stage 3 Lung Cancer?
Stage 3 lung cancer is the first stage that’s considered advanced cancer. In this stage the cancer has spread regionally, or to areas near the original tumor, classifying this stage as “locally advanced.” Stage 3 lung cancer characteristics can appear in various forms.
The beginning stages of advanced lung cancer are classified by 3A, 3B and 3C. These stages apply only to cases of non-small cell lung cancer, which is the type in 80% of lung cancer cases.
- Stage 3A lung cancer – characterized by only one cancer tumor (typically 5-7cm in size) in the affected lung; the cancer has not spread beyond the lung tissue, but lymph nodes within the lung and chest are positive for cancer.
- Stage 3B lung cancer – characterized by one or more tumors measuring 5-7cm; cancer may have spread to the lymph nodes above the collar bone and found on the opposite side of the chest; it can also extend to nearby organs and tissues of the heart, trachea, windpipe or lymph nodes in the mediastinum (the center of the chest).
- Stage 3C lung cancer – characterized by two or more tumors in the lung where the cancer originated; cancer has also spread to the lymph in the mediastinum (center of the chest), distant lymph nodes (in the neck and other side of the chest), distant tissues and structures (ribs, chest wall, trachea, spine, esophagus, or diaphragm).
What Symptoms to Expect for Stage 3 Lung Cancer
Most people with stage 3 lung cancer tumors start experiencing increasingly severe symptoms. Lung cancer is often diagnosed in the later stages after the cancer has spread beyond the lung to other organs and tissue, making symptoms more noticeable.
People with stage 3 lung cancer may experience symptoms including:
- Difficulty breathing
- Shortness of breath
- Persistent or worsening cough
- Bone pain
- Arm or leg weakness or numbness
- Dizziness or problems balancing
- Yellowing of the skin and eyes (jaundice)
- Swollen lymph nodes
Stage 3 Lung Cancer Treatment Options
Although stage 3 lung cancer is considered advanced, there are still many possible treatment options available to patients. Types of treatment for stage 3 lung cancer include surgical procedures, multimodal treatment with different types of therapies and clinical trials.
Treatment depends on the size of the tumor, the location of the tumor and the patient’s overall health status. Treatment options for stage 3 lung cancer are selected and tailored to each patient’s specific needs. Lung cancer specialists will determine the patient’s cancer status and choose the most appropriate treatment plan.
Stage 3 Lung Cancer Therapies
Stage 3 lung cancer is considered locally advanced. Oncologists often recommend aggressive systemic therapies as the initial treatment option. There are various lung cancer therapies used for this stage of lung cancer, such as chemotherapy, immunotherapy, radiation and targeted therapy. Each treatment is administered based on the patient’s overall health status. Some people with lung cancer are eligible for certain treatments, while others are not.
Most commonly, stage 3 lung cancer treatment starts with chemotherapy and radiation therapy, also known as chemoradiation or chemoradiotherapy.
Chemotherapy treatment for lung cancer uses drugs to attack cancer cells and stop them from growing or spreading to other organs. This is done by killing them or blocking them from reproducing or replicating. Chemotherapy for stage 3 cancer is often combined with other modes of treatment like surgery or radiation.
Radiation therapy is often a recommended treatment if surgery is not an option. Radiation involves the use of specialized equipment to administer high-energy waves that damage the cancer cells and shrink tumors over a period of time. These powerful radiation waves target the cancer cells and damage the genes in the cells, preventing the cells from growing and reproducing, resulting in cell death.
Immunotherapy boosts the patient’s immune system to identify and attack cancer cells. The most commonly used immunotherapy drugs are called checkpoint inhibitors. Cancer cells often send signals that trick the immune system into thinking the cancer cells are healthy cells.
Checkpoint inhibitors are designed to detect these fake signals and alert the immune system, causing the body to attack cancer cells. Common checkpoint inhibitor immunotherapy drugs include nivolumab (Opdivo®), ipilimumab (Yervoy®), pembrolizumab (Keytruda®), and atezolizumab (Tecentriq®).
Targeted therapy is a common type of lung cancer treatment involving specialized drugs that target certain genes and proteins driving the growth and spread of lung cancer. Targeted therapies are typically small-molecule drugs or monoclonal antibodies. This means the elements used to formulate targeted therapy drugs exist solely to kill cancer cells or shrink tumors.
Stage 3 Lung Cancer Surgery
For stage 3 lung cancer patients, surgery is not typically a first-line treatment option. Surgery is often difficult and complex due to the size of the cancer tumor or the spread of cancer outside the lung to other parts of the body. Lung cancer treatment is specialized for each patient, so there may be specific circumstances allowing for lung cancer surgery.
The most common surgical approach for lung cancer is a lobectomy. During this procedure, the surgeon removes one or more of the lobes of the lung containing cancer tumors. A lobectomy is only recommended for healthier patients who can survive surgery and manage the recovery.
This approach is not a common choice for stage 3 lung cancer based on the extent of the disease and the fact that removing a lobe or two of the lung may not be aggressive enough to remove all or most of the cancer effectively.
Other surgical options include sleeve resection, segmentectomy or wedge resection. These surgeries do not require the removal of the entire lung or even an entire lobe – only the removal of small pieces (segments or wedges) of the lobe.
These procedures are generally better options for early-stage lung cancer than more advanced stage 3 lung cancer patients with possible underlying health issues. Stage 3 lung cancer usually means the cancer has spread to lymph nodes and other areas of the body – resulting in widespread advancement of the cancer. Patients with advanced stages of lung cancer are typically less likely to be healthy enough to withstand the surgery and its lasting effects, and the surgery will most likely not remove all the cancer.
The last surgery for stage 3 lung cancer is a pneumonectomy. This removes the entire lung, which might be necessary at this stage of the disease. However, the patient’s health must be considered since they’ll only have one remaining lung.
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Stage 3 Lung Cancer Survival Rate
Stage 3 lung cancer is on the brink of advanced-stage lung cancer. The prognosis for stage 3 lung cancer depends entirely on the subcategory (3A, 3B or 3C) of the cancer. During stage 3 lung cancer, the cancer can display varying characteristics, so much so that each subcategory has vastly different survival rates.
The approach to measuring a patient’s survival after lung cancer treatment is called a 5-year relative survival rate. It compares people with the same type and stage of cancer – in this case, stage 3 lung cancer – to people in the general population.
The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results (SEER) database, maintained by the National Cancer Institute (NCI), to provide survival statistics for cancer patients. The SEER database analyzes 5-year survival rates for lung cancer patients in the United States. The database does not categorize the survival rates by the typical cancer stages but by how and where the cancer has spread.
According to the American Cancer Society, if non-small cell lung cancer is confined to one lung (localized), the 5-year relative survival rate is 64%. However, if the cancer has spread to areas surrounding the lung, the 5-year survival rate is 37%. If the cancer has spread beyond the lung to more distant parts of the body, the 5-year survival rate is 8%.
Frequently Asked Questions About Stage 3 Lung Cancer
What is stage 3 lung cancer?
Stage 3 of is the turning point of advanced lung cancer. Stage 3 is subcategorized by stage 3A, 3B and 3C. The status of the cancer is based on one of these subcategories, which are widely different from each other.
What are the symptoms of stage 3 lung cancer?
Symptoms of stage 3 lung cancer are typically more advanced. Some symptoms might include breathing difficulty, shortness of breath, coughing, bone pain, headache, arm or leg weakness or numbness, dizziness or problems balancing, seizures, yellowing of the skin and eyes (jaundice) or swollen lymph nodes.
Is stage 3 lung cancer curable?
Currently, there is no known cure for stage 3 lung cancer. There are many treatment options available to help control symptoms and allow the patient living with lung cancer to extend their life expectancy.
How can you treat stage 3 lung cancer?
Most lung cancer specialists will recommend chemoradiation as a first-line treatment option. Due to the advanced nature of stage 3 lung cancer, surgery is typically not an option. You should speak with a doctor to learn about the symptoms of lung cancer, the testing involved in making a diagnosis and discuss different treatment options tailored to your specific needs.
Sources & Author
- What is stage 3 lung cancer? Cancer Treatment Centers of America. Retrieved from: https://www.cancercenter.com/cancer-types/lung-cancer/stages/stage-3-lung-cancer. Accessed: 08/22/22.
- Immunotherapy. Cancer Treatment Centers of America. Retrieved from: https://www.cancercenter.com/treatment-options/precision-medicine/immunotherapy. Accessed: 08/23/22.
- Stage 3 lung cancer: What you should know. MedicalNewsToday. Retrieved from: https://www.medicalnewstoday.com/articles/316450#:~:text=Currently%2C%20there%20is%20no%20cure,another%205%20years%20or%20longer%20.. Accessed: 08/24/22.
- Stage IIIA Non-Small Cell Lung Cancer. Retrieved from: https://www.vacancer.com/cancer/lung-cancer/non-small-cell-lung-cancer/stage-iiia-non-small-cell-lung-cancer/#:~:text=Stage%20IIIA%20non%2Dsmall%20cell%20lung%20cancer%20(NSCLC)%20is,into%20N1%20and%20N2%20subgroups. Accessed: 10/18/2023.
- Lung Cancer – Non-Small Cell: Stages. Retrieved from: https://www.cancer.net/cancer-types/lung-cancer-non-small-cell/stages. Accessed: 10/18/2023.