Stage 1 lung cancer does not always cause symptoms. When they do occur, stage 1 lung cancer symptoms can include shortness of breath, a persistent cough, coughing up blood or blood-stained phlegm, and more.

Lung cancer is one of the most common types of cancer. Approximately 6.3% of adults in the United States will receive a lung cancer diagnosis in their lifetime.

There are two main forms of lung cancer, which are:

  • Non-small-cell lung cancer (NSCLC): This accounts for more than 87% of cases. There are three types, which include squamous cell carcinoma, adenocarcinoma, and large-cell carcinoma.
  • Small-cell lung cancer (SCLC): This is a less common form that tends to spread faster than NSCLC.

This article will outline the symptoms of stage 1 lung cancer, the treatment options available, and when a person should seek medical help.

A man wearing a green jumper and coughing as he may have symptoms of stage 1 lung cancer.Share on Pinterest
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People with stage 1 lung cancer may not have any symptoms at all.

According to a 2020 article, by the time symptoms develop, the cancer can be quite advanced.

As a result, healthcare professionals may only discover that a person has lung cancer during an x-ray or other scan for a different reason.

Some people with stage 1 lung cancer will notice symptoms, but they vary from person to person.

The common symptoms of lung cancer include:

  • shortness of breath when doing daily tasks
  • persistent cough that has not disappeared after 2–3 weeks
  • coughing up blood or blood-stained mucus

Additional symptoms of lung cancer include:

  • appetite loss
  • weight loss
  • general fatigue
  • shoulder, chest, or back pain
  • hoarse voice
  • harsh sounds with each breath, or stridor
  • recurrent lung problems, such as bronchitis or pneumonia

Additionally, the British Lung Foundation notes that if the tumor has spread outside the lungs, the first symptoms may not come from the chest. These symptoms may include:

  • pain in the back
  • bone pain
  • confusion
  • swallowing difficulties
  • nerve or brain damage that can affect talking, walking, memory, or behavior
  • jaundice, which is the yellowing of the skin and eyes

However, at this point, the lung cancer may have progressed to later stages.

Most lung cancers do not cause symptoms until they have spread.

Symptoms usually develop slowly after the lung cancer has been growing for some time. This results in a majority of patients with lung cancer having advanced disease by the time they see a doctor.

An early diagnosis of lung cancer is important. A person should contact a doctor if they experience any symptoms of lung cancer.

The U.S. Preventive Services Task Force recommends yearly screening for lung cancer for those who:

  • have smoked an average of at least 20 packs of cigarettes in a year
  • currently smoke or quit within the past 15 years
  • are aged between 50–80

The Centers for Disease Control and Prevention note that most insurance plans and Medicare will help to cover the costs for recommended screening tests.

Health insurance policies should cover lung cancer screening tests without a co-pay or a deductible.

Learn more about what coverage Medicare provides for lung cancer here.

According to Cancer Research UK, stage 1 lung cancer is divided into two sub-stages:

  • Stage 1A: The cancer is 3 centimeters (cm) or smaller.
  • Stage 1B: The cancer is between 3 cm and 4 cm. At stage 1B, the cancer might also be growing into:
    • the main airway of the lung, or main bronchus.
    • the membrane covering the lung, or visceral pleura.

At stage 1B, the cancer might also block the airway, causing the lung to partly or completely collapse.

Learn more about the different stages of lung cancer here.

Treatment options for stage 1 lung cancer depend on:

  • the primary type of lung cancer
  • the location
  • a person’s general health and age
  • other health conditions a person may have

If a person smokes, a healthcare professional will encourage them to quit before treatment begins.

Research has found that those who quit smoking after receiving a diagnosis have better outcomes than those who do not.

Treatment for stage 1 NSCLC

According to the American Cancer Society, a person may only require surgery for stage 1 NSCLC.

Surgeons will assess a person’s overall health before deciding on an appropriate treatment.

A surgeon may perform the following procedures:

  • a pneumonectomy, which is the removal of the entire lung
  • a lobectomy, which is the removal of the lobe that contains the tumor
  • a sleeve resection, segmentectomy, or wedge resection, which is the removal of a smaller piece of the lung

A surgeon may also remove some lymph nodes in the lung and in the space between the lungs to check for cancer.

After surgery, a person may undergo chemotherapy, which can lower the chance of cancer returning.

If surgery is not an option, a person may undergo:

  • radiotherapy
  • radiofrequency ablation
  • stereotatic body radiation therapy

Treatment for stage 1 SCLC

Healthcare professionals typically recommend chemotherapy to treat stage 1 SCLC. If the cancer has spread to the nearby lymph nodes, a person can undergo radiotherapy alongside the chemotherapy.

Surgery is a rare option, but may be appropriate if the cancer is small and has not spread.

According to the American Cancer Society, the 5-year relative survival rates for lung cancer compare people with the same type and stage of cancer to people in the overall population.

For example, if the 5-year survival rate is 40%, this means people with that type of cancer are 40% as likely as someone who does not have that cancer to live for at least 5 years after receiving a lung cancer diagnosis.

The survival rate also depends on how far the cancer has spread:

  • Localized: This means that the cancer has not spread outside of the lung.
  • Regional: This means that the cancer has spread to the lymph nodes or areas nearby.
  • Distant: This means that cancer has spread to other parts of the body, such as the liver, bones, brain, or other lung.

Based on people diagnosed with lung cancer between 2010 and 2016, the 5-year survival rates in those categories, which are different than stages, are as follows:

All of the stages combined:25%7%

A 2017 article notes that if a healthcare professional diagnoses NSCLC at stage 1, the 5-year survival rate is 70–90%. At this point, the tumor will be small and localized.

SCLC is more aggressive and the window for treatment is small. However, if a diagnoses occurs at stage 1, surgery may still be beneficial. A 2016 study found that the survival rate for stage 1 SCLC is 40%, and 52% if a person undergoes surgery alongside chemotherapy and radiotherapy.

These rates change as treatments improve. A healthcare professional can provide more information on a person’s survival rates.

Initially, a healthcare professional will discuss a person’s medical history and ask about the symptoms they have been experiencing.

A doctor may then order initial imaging tests, such as an x-ray.

If a chest X-ray suggests a person has lung cancer, the next step towards diagnosis is to have a CT scan or a PET scan. A CT scan uses X-rays and a computer to create detailed images inside the body. A lung positron emission tomography (PET) scan is an imaging test that uses a radioactive substance, called a tracer, to look for diseases in the lungs such as lung cancer. Unlike CT scans, which mainly evaluate the structure of the lungs, a PET scan shows how well the lungs and their tissues are working.

If a CT or PET scan suggests that cancer is present in the lung, a person may be offered a bronchoscopy or a CT scan-guided biopsy depending on the location and accessibility of the suspicious area in the lung. Bronchoscopy is a procedure that allows a doctor to see inside a person’s airways and remove a small sample of cells, known as a biopsy. A biopsy can show if cancerous cells are growing in that location and what type they are.

Usually, the patient’s case is presented to a multidisciplinary lung tumor board to determine the best and safest way to start the evaluation, obtain tissue, and initiate treatment.

People do not typically experience symptoms in stage 1 lung cancer. By the time a person notices symptoms, their cancer may have reached more advanced stages.

However, people should seek medical help if they experience shortness of breath, a persistent cough, or coughing up blood or blood-tinged phlegm.