When lung cancer reaches stage 3, it has begun to spread beyond the lung where it started. Doctors may call this stage "locally advanced." Cancer has not yet spread to more distant parts of the body.

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

This will depend on a range of factors, including the type of cancer.

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

Other factors that will affect the outlook include a person's age and overall health.

However, people do not always notice symptoms at stage 1 or 2. For this reason, only around 15% of people receive a diagnosis in the early stage.

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

Read on to find out more about what stage 3 lung cancer involves and what to expect.

What are the differences between SCLC and NSCLC? Find out more.

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When lung cancer has spread beyond the lung, it is stage 3.

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 it is likely to respond to specific treatments.

A straightforward way to describe cancer development is:

Localized: Cancer is only in the original site and has not spread.

Regional: Cancer has spread to nearby tissues.

Distant: Cancer has metastasized, or spread to other parts of the body and may affect the bones, liver, and brain.

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

Learn more here about metastatic lung cancer.

Numbered stages

A doctor may use numbered stages to describe NSCLC. The stages range from 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 originated, but it has not yet begun to 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 cancer has affected.

SCLC: Limited or extensive SCLC

For SCLC, doctors use a different system:

Limited: Cancer affects one lung and lymph nodes on the same side of the body.

Extensive: The primary tumor has spread further 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 parts of the body, such as the other lung, the liver, and other organs?

Doctors use TNM stages to describe both SCLC and NSCLC. They will give numbers to each aspect.

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

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Chest pain is a common symptom of stage 3 lung cancer.

By stage 3, a person with lung cancer will usually have symptoms. Small and non-small cell lung cancer have similar symptoms.

However, these can vary between individuals. The location, size, and growth rate of the tumor can all affect how symptoms appear.

Common symptoms include:

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

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

The person may have bone pain, jaundice, and other symptoms.

Treatment for cancer can be aggressive. All the treatment options can lead to further symptoms and complications.

For more information on the complications of lung cancer, click here.

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

Chemotherapy: This is often effective in treating lung cancer.

Radiation therapy: This may be useful in some cases. It can shrink a tumor before surgery,

Surgery: This can help in situations where cancer is not yet widespread. A surgeon may remove all or part of a lung, and any nearby lymph nodes where cancer has spread.

Targeted therapy: This 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: This is an emerging type of treatment. The doctor will give drugs that can enhance the way the immune system fights cancer.

Laser therapy: This uses a laser beam to kill cancer cells.

Endoscopic stent: If a tumor blocks an airway, a surgeon may use an endoscope to insert a stent. This can help keep the airway open.

Some people opt to participate in clinical trials. This can give them access to new medicines and techniques that are not otherwise available. Researchers only carry out clinical trials 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. Many people also experience depression and anxiety.

People should speak to their doctor about these problems, as they can often help. They may prescribe medication or recommend counseling, for example. They may 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:

  • quitting smoking and avoiding second-hand smoke
  • eating healthfully
  • getting exercise
  • relaxation techniques, such as massage therapy and yoga

Anyone with a diagnosis of cancer 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 to their doctor first.

Making the right dietary choices may boost a person's health, even with a diagnosis of stage 3 cancer. Find out more here about foods to eat and avoid.

Factors affecting treatment decisions

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

  • the stage of the cancer
  • the type of cancer
  • the ages and overall health of the individual
  • personal preferences

Many people with stage 3 lung cancer will undergo the most aggressive form of treatment possible, as this may give a better chance of survival. A doctor will discuss the pros and cons of the available options at this stage.

The American Cancer Society (ACS) give statistics showing how many people can expect to live another 5 years or more after a diagnosis of cancer 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

Small cell lung cancer

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

29% when it is localized

15% when it is regional

3% when it is distant

6% overall

Improvements in diagnosis and treatment have led to improved survival rates for most cancers in recent years.

In 1975–1977, only 34.4% of people with any stage of lung cancer lived a year or more after diagnosis. By 2006–2009, this figure had risen to 44.7%.

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. One way to resolve this is to find ways to get an earlier diagnosis.

Chronic obstructive pulmonary disease (COPD), like lung cancer, usually results from smoking. It can also have similar symptoms to lung cancer. Find out more about the links between these two diseases.

Improving the outlook through screening

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People ages 55–80 should consider regular screening.

Screening might help detect more lung cancers in the early stages.

There is no standard way to screen for lung cancer. The only recommended test, according to the Centers for Disease Control and Prevention (CDC), is a low-dose computed tomography (LDCT) 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) recommend annual screening for anyone who meets the three following criteria:

  • They have a history of heavy smoking.
  • They are current smokers or have stopped within the last 15 years.
  • They are 55–80 years old.

A heavy smoker is one has who smoked the equivalent of one pack of cigarettes each day for a total of 30 years. For a person who smoked two packs a day, they would be a heavy smoker if they did so for 15 years.

The USPSTF add that screening is not recommended for anyone who would be unable or unwilling to undergo surgery if doctors found lung cancer.

The National Cancer Institute (NCI) note that scientists are looking at other ways of screening for lung cancer, such as:

  • sputum cytology, which looks for cancer cells in the mucus
  • a chest X-ray

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

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, MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.