Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Typically, stage 1 lung cancer does not cause any outward symptoms. Because of this, only 12% to 15% of NSCLCs are detected when they’re still in this stage.
There are a few options for stage 1 lung cancer treatment, with surgery being the most common. With prompt treatment, the prognosis is very good.
2:57An Overview of Staging For Non-Small Cell Lung Cancer
2:57
An Overview of Staging For Non-Small Cell Lung Cancer
Stage 1 Lung Cancer Symptoms
A stage 1non-small cell lung cancer tumoris unlikely to cause symptoms. This is because it is small and contained within the lungs.
In the rare instances that stage 1 lung cancer does cause symptoms, they may include:
When lung cancer causes pain, it is often felt in the chest.Because of the size and location of a stage 1 tumor, however, it doesn’t usually cause significant pain or other symptoms common in advanced stages, such as fatigue or unintentional weight loss.
When there is no known risk of lung cancer, healthcare providers can miss subtle signs of this disease. In fact, a third of people who are eventually diagnosed with lung cancer visit their healthcare provider three or more times with symptoms that are related to cancer before being accurately diagnosed.
All forms of lung cancer occur when the DNA of healthy, normal cells becomes damaged. As a result, the cells undergo mutations and other changes that cause them to grow uncontrollably.
The most common reasoncancer cellsdevelop in the lungs is exposure to certain chemicals inhaled while smoking cigarettes. There are more than 60 carcinogens (cancer-causing) substances in cigarettes, including formaldehyde, acrylamide, inorganic lead, and various hydrocarbons.
While cigarette smoking is the number one risk factor for lung cancer, there are others you need to be aware of:
Because it rarely causes symptoms, stage 1 lung cancer is more likely to be found incidentally than intentionally. It most often shows up on achest X-rayorcomputerized tomography (CT)scan that has been performed for an entirely different reason, such as to diagnose pneumonia.
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Early stage lung cancer also can be detected with screening using CT imaging, which the U.S. Preventive Services Task Force recommends for certain people who are or have been smokers and mee the following conditions:
The American Cancer Society has the same screening criteria, except it doesn’t limit screening to 15 years after quitting. They recommend it indefinitely.
Once lung cancer is suspected, other tests, such aspositron emission tomography (PET) imaging, sputum or blood test, or biopsy are used toconfirm a diagnosisand to stage the cancer.
Stage 1a vs. Stage 1b
Stagingis a refinement of a general diagnosis that describes how advanced a cancer is.
Lung cancer is staged based on the TNM system, in which T stands for tumor size, N stands forlymph nodes, and M stands for metastasis.
According to the TNM system, once diagnosed, stage 1 lung cancer can be designated as either stage 1A (which encompasses three sub-stages) or stage 1B.
StageT, N, M DesignationTumor Size and Lung Involvement1A1T1mi, N0, M0Minimally invasiveadenocarcinomano more than 3 centimeters (cm) in sizePortion of tumor in lung tissues is no larger than 0.5 cmT1a, N0, M0No more than 1 cmHas not grown into membranes surrounding the lungsDoes not affect the main branches of the bronchi1A2T1b, N0, M0Between 1 and 2 cmHas not reached membranes around the lungsDoesn’t affect the main branches of the bronchi1A3T1c, N0, M0Between 2 and 3 cmHas not reached membranes around the lungsDoesn’t affect the main branches of the bronchi1BT2a, N0, M0Between 3 and 4 cm ORMeets one or more of the following criteria: 1) Has grown into a main bronchus, irrespective of the distance to the carina 2) Has grown into the membranes surrounding the lungs 3) Partially clogs the airwaysMetastases are not found with any substage of stage 1 non-small cell lung cancer.TreatmentTreatment options for stage 1 lung cancer range from surgery to chemotherapy to radiation. Which route you take depends on a variety of factors, including overall health, if it’s progressed to stage 1B, and personal choice. Talk to your healthcare provider about the best options for you.SurgerySurgery to remove the tumor is the most common treatment of choice for stage 1 lung cancer.There are three procedures for doing this:Wedge resection (segmental resection):This involves the removal of a wedge-shaped portion of the lung that includes the entire growth along with some surrounding tissue.Lobectomy:The right lung has three lobes and the left lung has two lobes. Alobectomyinvolves removing one of the five. It’s the most common surgery used to treat lung cancer.Segmentectomy:The lobes of the lung are divided into segments. One of these segments may be entirely removed along with a tumor to ensure the cancer cells are eradicated.Surgery to remove a lung tumor may be performed with an open chestthoracotomyin which a large incision is made in the chest and the ribs are pulled out of the way to give the surgeon direct access to the lungs.A video-assisted thoracoscopic surgery (VATS) is a less invasive procedure. Small incisions are made and video-equipped instruments are inserted for removal of the tissue without fully opening the chest.Recovery is quicker with VATS, which is an advantage. However, not all healthcare providers perform this type of surgery, and VATS instruments may not reach the tumor if it isn’t accessible via a small incision.ChemotherapyFor people with stage 1 lung cancer,chemotherapymay be used after surgery to improve the chances that all cancer cells have been destroyed. It’s mostly used in cases where someone has stage 1B non–small cell lung cancer. A combination of cisplatin and vinorelbine is the most common drug option.However, chemotherapy following surgery as a stage 1 lung cancer treatment remains controversial because the benefits are not very high and it may put you at risk for other health issues.RadiationFor someone who isn’t healthy enough to tolerate surgery or if a tumor is inoperable—for example, situated in a way that makes it hard to access—radiation therapymay be used. This involves aiming high-energy radiation toward the cancer cells to kill them and shrink tumors.For people with stage 1 lung cancer, a specialized type of radiation therapy known asstereotactic body radiotherapy (SBRT), also called a cyberknife procedure, may be an option as it can target small areas with high doses of radiation.Radiation therapy to the lungs may cause side effects such as a cough or shortness of breath.PrognosisStudies have shown that anywhere from 70% to 92% of people with stage 1 NSCLC are expected to live at least five years following their diagnosis.Stage 1 lung cancersurvival ratesare better for people who are able to undergo surgery to remove all of their cancer. For stage 1, the five-year survival after surgery is around 80%, versus about 40% for SBRT alone.Survival rates may be better for those whose cancer is not causing symptoms and is first found via a CT screening.Thus, efforts to improve early screenings could help ensure a better prognosis for lung cancer patients.Stage 1 Lung Cancer Recurrence RateIt’s estimated that lung cancer will recur in 30% to 50% of patients who were treated for stage 1 lung cancer.This can happen locally or in distant sites in the body, even with successful surgery.Most often,recurrent cancerwill not appear at the same site as theprimary tumor. Lung cancer often spreads first to the lymph nodes in the lungs and airways.It may also spread to other locations such as thebrain,bones, orliver. Theprognosis is much worseif lung cancer spreads in this way.In those who have smoked in the past, there is also a risk of developing a second primary tumor that’s related to smoking, either in the lungs or in other regions of the body.SummaryA lung cancer diagnosis, regardless of stage, is cause for concern. That said, the prognosis for stage 1 non-small cell lung cancer is excellent once the tumor has been removed.Smoking is the primary risk factor, but exposure to radon, air pollution, and certain chemicals also contribute. Treatment typically includes surgery, with options like lobectomy or less invasive methods like VATS; radiation or chemotherapy may be alternatives for inoperable cases.
Metastases are not found with any substage of stage 1 non-small cell lung cancer.
Treatment options for stage 1 lung cancer range from surgery to chemotherapy to radiation. Which route you take depends on a variety of factors, including overall health, if it’s progressed to stage 1B, and personal choice. Talk to your healthcare provider about the best options for you.
Surgery
Surgery to remove the tumor is the most common treatment of choice for stage 1 lung cancer.
There are three procedures for doing this:
Surgery to remove a lung tumor may be performed with an open chestthoracotomyin which a large incision is made in the chest and the ribs are pulled out of the way to give the surgeon direct access to the lungs.
A video-assisted thoracoscopic surgery (VATS) is a less invasive procedure. Small incisions are made and video-equipped instruments are inserted for removal of the tissue without fully opening the chest.
Recovery is quicker with VATS, which is an advantage. However, not all healthcare providers perform this type of surgery, and VATS instruments may not reach the tumor if it isn’t accessible via a small incision.
Chemotherapy
For people with stage 1 lung cancer,chemotherapymay be used after surgery to improve the chances that all cancer cells have been destroyed. It’s mostly used in cases where someone has stage 1B non–small cell lung cancer. A combination of cisplatin and vinorelbine is the most common drug option.
However, chemotherapy following surgery as a stage 1 lung cancer treatment remains controversial because the benefits are not very high and it may put you at risk for other health issues.
Radiation
For someone who isn’t healthy enough to tolerate surgery or if a tumor is inoperable—for example, situated in a way that makes it hard to access—radiation therapymay be used. This involves aiming high-energy radiation toward the cancer cells to kill them and shrink tumors.
For people with stage 1 lung cancer, a specialized type of radiation therapy known asstereotactic body radiotherapy (SBRT), also called a cyberknife procedure, may be an option as it can target small areas with high doses of radiation.
Radiation therapy to the lungs may cause side effects such as a cough or shortness of breath.
Studies have shown that anywhere from 70% to 92% of people with stage 1 NSCLC are expected to live at least five years following their diagnosis.
Stage 1 lung cancersurvival ratesare better for people who are able to undergo surgery to remove all of their cancer. For stage 1, the five-year survival after surgery is around 80%, versus about 40% for SBRT alone.
Survival rates may be better for those whose cancer is not causing symptoms and is first found via a CT screening.Thus, efforts to improve early screenings could help ensure a better prognosis for lung cancer patients.
Stage 1 Lung Cancer Recurrence Rate
It’s estimated that lung cancer will recur in 30% to 50% of patients who were treated for stage 1 lung cancer.This can happen locally or in distant sites in the body, even with successful surgery.
Most often,recurrent cancerwill not appear at the same site as theprimary tumor. Lung cancer often spreads first to the lymph nodes in the lungs and airways.It may also spread to other locations such as thebrain,bones, orliver. Theprognosis is much worseif lung cancer spreads in this way.
In those who have smoked in the past, there is also a risk of developing a second primary tumor that’s related to smoking, either in the lungs or in other regions of the body.
Summary
A lung cancer diagnosis, regardless of stage, is cause for concern. That said, the prognosis for stage 1 non-small cell lung cancer is excellent once the tumor has been removed.
Smoking is the primary risk factor, but exposure to radon, air pollution, and certain chemicals also contribute. Treatment typically includes surgery, with options like lobectomy or less invasive methods like VATS; radiation or chemotherapy may be alternatives for inoperable cases.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Key statistics for lung cancer.U.S. Preventive Services Task Force.Screening for lung cancer: US Preventive Services Task Force Recommendation Statement.JAMA.2021;325(10):962–970. doi:10.1001/jama.2021.1117American Cancer Society.Lung Cancer Signs and Symptoms.Johns Hopkins Medicine.Lung cancer warning signs.Bradley SH, Kennedy MPT, Neal RD.Recognising lung cancer in primary care.Adv Ther. 2019;36(1):19-30. doi:10.6084/m9.figshare.7334852Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). Atlanta (GA).How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General.de Groot PM, Wu CC, Carter BW, Munden RF.The epidemiology of lung cancer.Transl Lung Cancer Res. 2018;7(3):220–233. doi:10.21037/tlcr.2018.05.06Wolf AMD, Oeffinger KC, Shih TY, et al.Screening for lung cancer: 2023 guideline update from the American Cancer Society.CA Cancer J Clin. 2023;10.3322/caac.21811. doi:10.3322/caac.21811American Cancer Society.Non-Small Cell Lung Cancer.American Cancer Society.Surgery for Non-Small Cell Lung Cancer.Canadian Cancer Society.Treatments for stage 1 non–small cell lung cancer.Chae Y, Oh M.Detection of minimal residual disease using ctDNA in lung cancer:Jour Thora Onc.2019;1(14):16-24. doi:10.1016/j.jtho.2018.09.022American Cancer Society.Radiation therapy for non-small cell lung cancer.Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P.Revisions to the Tumor, Node, Metastasis staging of lung cancer (8 edition): Rationale, radiologic findings and clinical implications.World J Radiol. 2017;9(6):269-79. doi:10.4329/wjr.v9.i6.269Albano D, Bilfinger T, Nemesure B.1-, 3-, and 5-year survival among early-stage lung cancer patients treated with lobectomy vs SBRT.Lung Cancer (Auckl). 2018;9:65-71. doi:10.2147%2FLCTT.S166320American Cancer Society.Can Lung Cancer Be Found Early?Blandin Knight S, Crosbie PA, Balata H, Chudziak J, Hussell T, Dive C.Progress and prospects of early detection in lung cancer.Open Biol. 2017;7(9). doi:10.1098%2Frsob.170070American Cancer Society.Non-small cell lung cancer stages.Reinmuth N, Stumpf A, Stumpf P, et al.Characteristics and outcome of patients with second primary lung cancer.Eur Respir J. 2013;42(6):1668-76. doi:10.1183/09031936.00022512
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Key statistics for lung cancer.U.S. Preventive Services Task Force.Screening for lung cancer: US Preventive Services Task Force Recommendation Statement.JAMA.2021;325(10):962–970. doi:10.1001/jama.2021.1117American Cancer Society.Lung Cancer Signs and Symptoms.Johns Hopkins Medicine.Lung cancer warning signs.Bradley SH, Kennedy MPT, Neal RD.Recognising lung cancer in primary care.Adv Ther. 2019;36(1):19-30. doi:10.6084/m9.figshare.7334852Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). Atlanta (GA).How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General.de Groot PM, Wu CC, Carter BW, Munden RF.The epidemiology of lung cancer.Transl Lung Cancer Res. 2018;7(3):220–233. doi:10.21037/tlcr.2018.05.06Wolf AMD, Oeffinger KC, Shih TY, et al.Screening for lung cancer: 2023 guideline update from the American Cancer Society.CA Cancer J Clin. 2023;10.3322/caac.21811. doi:10.3322/caac.21811American Cancer Society.Non-Small Cell Lung Cancer.American Cancer Society.Surgery for Non-Small Cell Lung Cancer.Canadian Cancer Society.Treatments for stage 1 non–small cell lung cancer.Chae Y, Oh M.Detection of minimal residual disease using ctDNA in lung cancer:Jour Thora Onc.2019;1(14):16-24. doi:10.1016/j.jtho.2018.09.022American Cancer Society.Radiation therapy for non-small cell lung cancer.Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P.Revisions to the Tumor, Node, Metastasis staging of lung cancer (8 edition): Rationale, radiologic findings and clinical implications.World J Radiol. 2017;9(6):269-79. doi:10.4329/wjr.v9.i6.269Albano D, Bilfinger T, Nemesure B.1-, 3-, and 5-year survival among early-stage lung cancer patients treated with lobectomy vs SBRT.Lung Cancer (Auckl). 2018;9:65-71. doi:10.2147%2FLCTT.S166320American Cancer Society.Can Lung Cancer Be Found Early?Blandin Knight S, Crosbie PA, Balata H, Chudziak J, Hussell T, Dive C.Progress and prospects of early detection in lung cancer.Open Biol. 2017;7(9). doi:10.1098%2Frsob.170070American Cancer Society.Non-small cell lung cancer stages.Reinmuth N, Stumpf A, Stumpf P, et al.Characteristics and outcome of patients with second primary lung cancer.Eur Respir J. 2013;42(6):1668-76. doi:10.1183/09031936.00022512
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Key statistics for lung cancer.U.S. Preventive Services Task Force.Screening for lung cancer: US Preventive Services Task Force Recommendation Statement.JAMA.2021;325(10):962–970. doi:10.1001/jama.2021.1117American Cancer Society.Lung Cancer Signs and Symptoms.Johns Hopkins Medicine.Lung cancer warning signs.Bradley SH, Kennedy MPT, Neal RD.Recognising lung cancer in primary care.Adv Ther. 2019;36(1):19-30. doi:10.6084/m9.figshare.7334852Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). Atlanta (GA).How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General.de Groot PM, Wu CC, Carter BW, Munden RF.The epidemiology of lung cancer.Transl Lung Cancer Res. 2018;7(3):220–233. doi:10.21037/tlcr.2018.05.06Wolf AMD, Oeffinger KC, Shih TY, et al.Screening for lung cancer: 2023 guideline update from the American Cancer Society.CA Cancer J Clin. 2023;10.3322/caac.21811. doi:10.3322/caac.21811American Cancer Society.Non-Small Cell Lung Cancer.American Cancer Society.Surgery for Non-Small Cell Lung Cancer.Canadian Cancer Society.Treatments for stage 1 non–small cell lung cancer.Chae Y, Oh M.Detection of minimal residual disease using ctDNA in lung cancer:Jour Thora Onc.2019;1(14):16-24. doi:10.1016/j.jtho.2018.09.022American Cancer Society.Radiation therapy for non-small cell lung cancer.Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P.Revisions to the Tumor, Node, Metastasis staging of lung cancer (8 edition): Rationale, radiologic findings and clinical implications.World J Radiol. 2017;9(6):269-79. doi:10.4329/wjr.v9.i6.269Albano D, Bilfinger T, Nemesure B.1-, 3-, and 5-year survival among early-stage lung cancer patients treated with lobectomy vs SBRT.Lung Cancer (Auckl). 2018;9:65-71. doi:10.2147%2FLCTT.S166320American Cancer Society.Can Lung Cancer Be Found Early?Blandin Knight S, Crosbie PA, Balata H, Chudziak J, Hussell T, Dive C.Progress and prospects of early detection in lung cancer.Open Biol. 2017;7(9). doi:10.1098%2Frsob.170070American Cancer Society.Non-small cell lung cancer stages.Reinmuth N, Stumpf A, Stumpf P, et al.Characteristics and outcome of patients with second primary lung cancer.Eur Respir J. 2013;42(6):1668-76. doi:10.1183/09031936.00022512
American Cancer Society.Key statistics for lung cancer.
U.S. Preventive Services Task Force.Screening for lung cancer: US Preventive Services Task Force Recommendation Statement.JAMA.2021;325(10):962–970. doi:10.1001/jama.2021.1117
American Cancer Society.Lung Cancer Signs and Symptoms.
Johns Hopkins Medicine.Lung cancer warning signs.
Bradley SH, Kennedy MPT, Neal RD.Recognising lung cancer in primary care.Adv Ther. 2019;36(1):19-30. doi:10.6084/m9.figshare.7334852
Centers for Disease Control and Prevention (US); National Center for Chronic Disease Prevention and Health Promotion (US); Office on Smoking and Health (US). Atlanta (GA).How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General.
de Groot PM, Wu CC, Carter BW, Munden RF.The epidemiology of lung cancer.Transl Lung Cancer Res. 2018;7(3):220–233. doi:10.21037/tlcr.2018.05.06
Wolf AMD, Oeffinger KC, Shih TY, et al.Screening for lung cancer: 2023 guideline update from the American Cancer Society.CA Cancer J Clin. 2023;10.3322/caac.21811. doi:10.3322/caac.21811
American Cancer Society.Non-Small Cell Lung Cancer.
American Cancer Society.Surgery for Non-Small Cell Lung Cancer.
Canadian Cancer Society.Treatments for stage 1 non–small cell lung cancer.
Chae Y, Oh M.Detection of minimal residual disease using ctDNA in lung cancer:Jour Thora Onc.2019;1(14):16-24. doi:10.1016/j.jtho.2018.09.022
American Cancer Society.Radiation therapy for non-small cell lung cancer.
Kay FU, Kandathil A, Batra K, Saboo SS, Abbara S, Rajiah P.Revisions to the Tumor, Node, Metastasis staging of lung cancer (8 edition): Rationale, radiologic findings and clinical implications.World J Radiol. 2017;9(6):269-79. doi:10.4329/wjr.v9.i6.269
Albano D, Bilfinger T, Nemesure B.1-, 3-, and 5-year survival among early-stage lung cancer patients treated with lobectomy vs SBRT.Lung Cancer (Auckl). 2018;9:65-71. doi:10.2147%2FLCTT.S166320
American Cancer Society.Can Lung Cancer Be Found Early?
Blandin Knight S, Crosbie PA, Balata H, Chudziak J, Hussell T, Dive C.Progress and prospects of early detection in lung cancer.Open Biol. 2017;7(9). doi:10.1098%2Frsob.170070
American Cancer Society.Non-small cell lung cancer stages.
Reinmuth N, Stumpf A, Stumpf P, et al.Characteristics and outcome of patients with second primary lung cancer.Eur Respir J. 2013;42(6):1668-76. doi:10.1183/09031936.00022512
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