Stage 3 lung cancer is when cancer has spread beyond the lung where it started but not to more distant parts of the body. A person may experience chest pain and wheezing, among other symptoms.

A person’s outlook with stage 3 lung cancer depends on various factors, including the type of lung cancer they have.

Around 15% of lung cancers are small cell lung cancers (SCLC). The others are non-small cell lung cancers (NSCLC), which spread more slowly and have a better outlook.

Other factors that can affect the outlook include a person’s age and overall health.

As with all labels that describe cancer, the stage alone can only estimate the outlook. It cannot predict what will happen.

People do not always notice symptoms at stage 1 or 2. For this reason, many people may not receive a diagnosis in an early stage.

Around one-third of people with lung cancer will receive a diagnosis at stage 3.

Read on to learn more about stage 3 lung cancer, what it involves, and what to expect.

Find out more about the differences between SCLC and NSCLC.

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There are different ways of describing the stages of lung cancer. Doctors use stages to help them decide where the cancer is at any time and how likely it is to respond to specific treatments.

The following terms describe cancer development in a straightforward way:

  • Localized: Cancer is only at the original site and has not spread.
  • Regional: Cancer has spread to nearby tissues.
  • Distant: Cancer has spread to other parts of the body. It may affect the bones, liver, or brain.

At stage 3, cancer is in the process of moving from the regional to the distant stage.

Learn more about metastatic lung cancer.

Numbered stages

A doctor may use numbered stages to describe NSCLC. The stages are 0–4, with 0 being the earliest stage and 4 being the most advanced, or distant, stage.

At stage 3, cancer has started to spread beyond the lung where it began. However, it has not yet spread to the rest of the body.

Experts subdivide stage 3 into 3A, 3B, and 3C, depending on the size of the tumor and which lymph nodes and other tissues the cancer is affecting.

SCLC: Limited or extensive

For SCLC, doctors use a different system:

  • Limited: Cancer affects one lung and the lymph nodes on the same side of the body.
  • Extensive: The primary tumor has spread farther in the chest or to other organs.

TNM stages

Another way of staging is the TNM system.

TNM focuses on:

  • Tumor size (T): How big is the tumor, and has it spread to other tissues or areas?
  • Lymph nodes (N): Has cancer spread to nearby lymph nodes?
  • Metastasis (M): Has it reached other organs, such as the other lung or the liver?

Doctors use TNM stages to describe both SCLC and NSCLC. They will assign a number for each aspect.

Cancer stages can be complex. Talking with a doctor can help a person understand how lung cancer is affecting them.

The American Cancer Society (ACS) provides statistics showing how many people can expect to live for 5 years or longer after a cancer diagnosis at each stage.

NSCLC

The average chances of surviving 5 years or more with NSCLC are:

  • 60% when it is localized
  • 33% when it is regional
  • 6% when it is distant
  • 23% overall

SCLC

The average chances of surviving 5 years or more with SCLC are:

  • 29% when it is localized
  • 15% when it is regional
  • 3% when it is distant
  • 6% overall

In recent years, improvements in diagnosis and treatment have led to improved survival rates for many cancers.

From 1989 to 1991, only 13% of people with any stage of lung cancer lived for 5 years or more after diagnosis. From 2011 to 2017, this figure rose to 22%.

Nevertheless, doctors often find stage 3 lung cancer challenging to treat. This is because the cancer is already spreading by the time a person notices symptoms. Diagnosing lung cancer at an early stage can improve a person’s outlook.

Improving the outlook through screening

Screening might help detect more lung cancers in the early stages. There is no standard way to screen for lung cancer.

According to the Centers for Disease Control and Prevention (CDC), the only recommended test is a low dose computed tomography test. This is a type of X-ray that scans the body and produces detailed images of the lungs.

The U.S. Preventive Services Task Force (USPSTF) recommends annual screening for anyone 50–80 years old who meets any of the following criteria:

  • has a history of heavy smoking
  • currently smokes
  • previously smoked and has stopped within the last 15 years

The USPSTF defines heavy smoking as smoking 1 pack of cigarettes per day for 20 years or 2 packs per day for 10 years.

In most cases, doctors will treat stage 3 lung cancer with a combination of treatments:

  • Chemotherapy: Chemotherapy is often effective in treating lung cancer.
  • Radiation therapy: Radiation therapy may be useful in shrinking a tumor before a person has surgery.
  • Surgery: This can help when cancer is not yet widespread. A surgeon may remove all or part of a lung and any nearby lymph nodes to which cancer has spread.
  • Targeted therapy: Targeted therapy involves drugs that target specific factors in the body. These factors, which may be genes or proteins, encourage the growth of cancer cells. Blocking them may prevent or delay the spread of cancer.
  • Immunotherapy: Immunotherapy involves drugs that can enhance the way the immune system fights cancer.
  • Laser therapy: This involves using a laser beam to kill cancer cells.
  • Endoscopic stent: A surgeon may use an endoscope to insert a stent if a tumor blocks a person’s airway. This can help keep the airway open.

Clinical trials

Some people opt to participate in clinical trials. This can give them access to new medicines and techniques that are not otherwise available.

Researchers carry out clinical trials only when scientific evidence suggests that a treatment is likely to be safe.

Palliative care and managing symptoms

A person with stage 3 lung cancer may experience pain or discomfort that stems from their cancer or the treatment they are receiving. Some people may also experience depression and anxiety.

A medical professional may recommend counseling or prescribe medications to manage symptoms of anxiety or depression. They may also be able to recommend a local or online support group that can help.

Complementary therapies

Some complementary therapies may enhance a person’s health and help them feel more comfortable during treatment.

These include:

  • touch-based practices, such as massage and chiropractic care
  • dietary supplements and herbs, such as cannabis
  • relaxation techniques, such as meditation and yoga

However, anyone with a cancer diagnosis should follow their treatment plan and their doctor’s instructions. There is no scientific evidence that any supplement, diet, or other therapy can cure cancer.

Anyone who is considering taking supplements or making another significant change to their lifestyle should speak with a healthcare professional first. Some supplements can interact with certain medications.

Making certain dietary choices may also improve a person’s health, even while they have stage 3 cancer.

Find out more about foods to eat and avoid.

Factors affecting treatment decisions

The treatment plan for each person can depend on various factors, including:

  • cancer stage
  • cancer type
  • age and overall health
  • personal preferences

Many people with stage 3 lung cancer will undergo a combination of treatments, as this may give them a better chance of recovery. A doctor will discuss the pros and cons of the available options at this stage.

By stage 3, a person with lung cancer will usually have symptoms. SCLC and NSCLC have similar symptoms. However, these can vary from person to person. The location, size, and growth rate of the tumor can all affect how symptoms appear.

Common symptoms include:

  • chest pain
  • difficulty breathing
  • wheezing
  • a persistent cough that may produce blood
  • blood in the saliva and mucus
  • hoarseness or voice changes
  • appetite loss and weight loss
  • pain or difficulty when swallowing
  • fatigue and weakness
  • swelling in the face, the veins of the neck, or both

As cancer progresses through stage 3, it starts to affect other parts of the body.

A person may have bone pain, a yellowish tint to their skin or eyes (jaundice), and other symptoms.

Cancer treatment can be aggressive. All the treatment options can lead to further symptoms and complications.

Find out more about the complications of lung cancer.

Like lung cancer, chronic obstructive pulmonary disease (COPD) usually results from smoking. It can also have similar symptoms to lung cancer.

Find out more about the links between these two diseases.

It is difficult to predict how long a person with stage 3 lung cancer may live. Some people may have many years ahead of them, whereas others may have months.

The CDC recommends that people get appropriate treatment when they need it. This includes treatment for the lung cancer itself and for any side effects.

People may benefit from joining support groups to share their experiences with others who are in similar situations. It may also be beneficial for people to work with a mental health professional to process their feelings.

The American Lung Association suggests that people make end-of-life plans in advance to minimize stress and upset. This can ensure that other people know a person’s wishes and can make informed choices about their end-of-life care, should it come to that.

According to the CDC, smoking causes 80–90% of lung cancer deaths in the United States. If a person smokes, the most important thing they can do for their health is to stop smoking. Avoiding secondhand smoke can also reduce a person’s risk of developing lung cancer.

People should also have their home tested for radon and try to avoid it as much as possible. Radon is a naturally occurring radioactive gas that can cause lung cancer. It has no color or smell, so testing is the only way to find out whether someone has had exposure to it.

Finally, avoiding known carcinogens can minimize the risk of developing lung cancer. This includes following workplace health and safety guidelines.

Currently, there is no cure for stage 3 lung cancer, but treatment can often help prolong life and relieve symptoms. In some cases, a person with stage 3 lung cancer may survive for 5 years or longer.

Q:

I gave up smoking last year, but I have just had a diagnosis of stage 3 lung cancer. My partner still smokes in the house. Will this make any difference to me now?

Anonymous

A:

Yes, it can make a difference. Secondhand smoke or continuing to smoke after a lung cancer diagnosis can also worsen the rate of survival. Smoke can promote the growth of cancer and decrease the effectiveness of cancer treatments.

Please ask your partner to refrain from smoking around you. And your partner should stop smoking, too, to reduce their risk of developing lung cancer.

Alana Biggers, MD, MPHAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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