Table of ContentsView AllTable of ContentsStagingSymptomsTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Staging
Symptoms
Treatment
Prognosis
Coping
As with mosttypes of lung cancer, symptoms of stage 3 NSCLC—such as a chronic cough or shortness of breath—can easily be confused for less serious conditions. For that reason, around 35% of people with lung cancer have stage 3 disease at the time of diagnosis.
This article discusses the causes of stage 3 NSCLC and how it is diagnosed. Learn more about the symptoms and treatment options involved with stage 3 NSCLC below.
2:57An Overview of Staging For Non-Small Cell Lung Cancer
2:57
An Overview of Staging For Non-Small Cell Lung Cancer
Oncologistsuse a classification system called theTNM systemto characterize the stages of lung cancer. T refers to tumor size, N refers to lymph node involvement, and M represents spread (metastasis).
The most current version of this system, called TNM 8, describes the stage of cancer using alphanumeric codes.
Stage 3Alung cancer is described as:
Stage 3Bis described as:
Stage 3Cis described as:
Tumors involving amalignant pleural effusion(fluid build-up containing cancer cells in thepleural cavitybetween the layers lining the lungs) were changed from stage 3B tostage 4in 2009.
Stage 3 Lung Cancer Symptoms
Stage 3 lung cancer symptoms are variable because of the wide spectrum of possibilities the stage encompasses.
Generallung cancer symptomsare common and include:
Beyond that, the specific location of the cancer and related issues can give rise to other symptoms. For example:
Symptoms of any cancer, such asfatigueandunintentional weight loss, may be present as well.
Symptoms of NSCLC
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The treatment of stage 3 lung cancer is the most controversial of all lung cancer stages. Here too, this is partly because this group of malignancies is so varied.
Stage 3 lung cancers have a poor survival rate. Because of that, the National Cancer Institute (NCI) states that everyone with stage 3 lung cancer be considered a candidate forclinical trials—studies that evaluate new treatments or combinations of treatments for lung cancer.
For people who are relatively healthy, a combination ofchemotherapyor chemotherapy andradiation therapyis often recommended. If individuals are unable to tolerate chemotherapy, radiation therapy can be used alone to treat symptoms such as pain and shortness of breath.
Targeted Therapy
It’s now recommended thatmolecular profiling (gene testing)be done for everyone with NSCLC, especiallylung adenocarcinoma. This can reveal mutations that may be treatable.
Tagrisso (osimertinib), an oral epidermal growth factor receptor (EGFR) inhibitor, has been approved for use in people with stage 3A NSCLC bearingEGFR mutations.No other tyrosine kinase inhibitors are approved in stage 3 lung cancer.
Resistance often develops over time, but next-generation medications are currently approved and being tested in clinical trials for when this occurs. For those withsquamous cell carcinoma of the lungs, anti-EGFR antibodies may be used.
Clinical trials are also studying medications that address other genetic changes in lung cancer.
Immunotherapy
While the drugs do not work for everyone, some people have achieved long-term, disease-free control of their cancer.
A large phase 3 randomized study published in 2022 demonstrated that people with resectable NSCLC who received Opdivo (nivolumab) plus platinum-based chemotherapy before surgery had a significantly longer event-free survival and a higher percentage of a pathological complete response than patients who received chemotherapy alone.
Surgery
Surgery offers a chance for a cure, but it is not always possible with tumors of this size.
When surgery is done to remove a stage 3A tumor, it is usually followed up withadjuvant chemotherapy(chemotherapy after surgery to kill any remaining cancer cells).
Still, the risk of cancerrecurrenceafter surgery is fairly high for people with stage 3A lung cancer.
Stage 3B Treatment
As with stage 3A, 3B cancers may be treated with chemotherapy, radiation therapy, targeted therapies, and immunotherapy.
Stage 3B cancers cannot usually be treated with surgery and are considered inoperable. However, in some cases, the use of chemotherapy and radiation is able to decrease the size of a tumor so that surgery is then possible. This is known as neoadjuvant therapy.
For people with stage 3 lung cancer, treatments can also be used forpalliativepurposes. Here, the focus of treatment is relieving symptoms such as pain and shortness of breath, rather than trying to control the malignancy.
In some cases, palliative therapy might actually improve survival for people with stage 3 lung cancer.
Lung Cancer Treatment Options
The overall five-yearsurvival ratesfor stage 3A and 3B lung cancer are 36% and 26%, respectively, but they can vary widely. The five-year survival rate for stage 3C lung cancer is less promising at 13%.
It’s important, however, to keep in mind that these statistics are based on how people did with lung cancer in the past. Since there have been more medications approved for the treatment of lung cancer in the last decade than during the four decades preceding it, these statistics are fairly unreliable inestimating actual life expectancy.
Prognosisis a prediction. An estimate. An open conversation with your healthcare provider about your specific case and what the prognosis can and cannot tell you can be helpful in putting this in perspective.
How Fast Does Lung Cancer Grow and Spread?
Studies suggest that learning what you can about your cancer helps with the outcome.Ask questions. Involve your loved ones and encourage them to ask questions as well. Consider joining asupport group. Learn about clinical trials that might be appropriate for your particular situation.
Learning about your cancer and going through treatment can take a tremendous amount of time. Ask for and allow your loved ones and friends to help and encourage you in your journey. Don’t lose hope—even if that hope is only to be as comfortable as possible while you enjoy the company of your loved ones.
A Word From Verywell
If you have a constellation of certain risk factors, you may be eligible for screening for lung cancer that may catch the disease well before it reaches stage 3. Screening with an annual low-dosecomputed tomography (CT)chest scan is recommended for people between ages 50 and 80 who have a 20pack-yearsmoking history and currently smoke or have quit smoking within the past 15 years.
According to the American Lung Institute, 8 million Americans are considered at high risk of lung cancer. If only half of these individuals were screened, over 12,000 lung cancer deaths could be avoided.If you meet all of the screening criteria, talk to your healthcare provider.
Why Is Lung Cancer Increasing in Non-Smokers?
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