Stage 2 lung cancer is when the tumor has grown to a certain size, or the cancer may have spread beyond the lungs and into the lymph nodes. A person with stage 2 lung cancer will need different treatment than someone with lung cancer at a different stage.

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Lung cancers occur when cells in certain parts of the lungs and airways grow and divide out of control.

The lungs are a part of the respiratory system. The respiratory system includes the organs and tissues that help a person take in oxygen and get rid of carbon dioxide.

When a person breathes, air enters through the nose or mouth and travels through the trachea (windpipe) to smaller airways called bronchi. Bronchi divide to form even smaller, branch-like pipes in the lungs called bronchioles that end in air sacs called alveoli.

Lung cancer typically forms in the cells lining the smaller airways, such as bronchi, and certain parts of the lung, such as the bronchioles or alveoli.

This article discusses what it means to have stage 2 lung cancer, types of lung cancer associated with stage 2, symptoms, treatment, and more.

There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

NSCLC is the most common type and accounts for 80–85% of all cases.

Doctors break down types of NSCLC into four stages to indicate how much the cancer has spread.

To classify the stage of the NSCLC, a doctor considers the tumor size, whether the cancer has spread, and where it has spread to. The stage of cancer also helps them to decide which treatment options a person requires and their potential outlook.

Doctors break stage 2 NSCLC down into two substages: 2A and 2B.

At stage 2, the tumor measures more than 4 centimeters in size, or the cancer has spread to nearby lymph nodes or other structures.

According to Cancer Research UK, healthcare professionals may refer to stage 2 NSCLC as early stage NSCLC. In addition, part of the affected lung may have collapsed.

SCLC spreads more quickly and grows faster than NSCLC, and accounts for about 10–15% of all cases. Doctors generally classify types of SCLC as limited stage or extensive stage in addition to using the numbered staging system.

The National Cancer Institute (NCI) states that in stage 2A NSCLC, the tumor measures between 4–5 centimeters. At this point, the cancer has not spread to the lymph nodes.

In addition, stage 2A can also mean that:

  • the cancer has spread to the innermost layer of the membrane that covers the lung
  • the cancer spread to the main bronchus but not to the carina, which is where the windpipe splits into the bronchi
  • there is partial or full lung collapse
  • part or all of the lung has developed pneumonitis

The NCI notes that in stage 2B NSCLC, the tumor has grown larger than 5 centimeters (cm) or has spread to the first level of local lymph nodes on the same side as the tumor.

In addition, a doctor may find one or more of the following features:

  • cancer that appears in the inner layer of the membrane surrounding the lung
  • the lung, or part of it, has collapsed or developed pneumonitis
  • cancer that appears in the main bronchus but not the carina

Alternatively, a doctor may discover that the cancer has not spread to lymph nodes. In this case, they may find one or more of the following:

  • the tumor size is between 5–7 cm
  • one or more separate tumors have developed in the same lobe of the lung as the primary tumor
  • the cancer has spread to one or more of the following areas:
    • the outer layer of tissue of the sac around the heart
    • the chest wall’s inner membrane
    • the chest wall
    • the nerve that controls the diaphragm

According to the American Cancer Society (ACS), most people living with lung cancer will not experience symptoms until it has spread.

When they occur, some common symptoms that could indicate lung cancer include:

It is important to note that, though these could indicate lung cancer, they could also indicate several other, more common issues.

According to the ACS, if a person with stage 2 NSCLC is well enough, they can undergo surgery to remove the cancer.

A surgeon will perform a lobectomy or sleeve resection. In some cases, they will perform a pneumonectomy, which is the removal of the whole lung.

They will also remove any affected lymph nodes, which can help with planning the next steps of treatment.

If a healthcare professional finds cancer cells near the edges of the removed tissues, a person may need additional surgery, followed by chemotherapy. A person may also receive immunotherapy with atezolizumab for up to a year.

For those with EGFR-positive lung cancer, a healthcare professional may recommend targeted drug therapy using osimertinib.

For those who cannot or choose not to undergo surgery, radiation therapy with or without chemotherapy may be the primary form of treatment.

The ACS provides an estimated 5-year relative survival rate for lung cancer as a general guide.

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, it means that a person with the condition is 70% as likely to live for 5 years as someone without the condition.

The ACS uses the SEER database, which groups cancers into the following stages:

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

A person’s 5-year relative survival rate for localized NSCLC is 63%, and for regional NSCLC is 35%. Stage 2 lung cancer straddles the border of these two and likely has survival somewhere in between.

Survival for all stages may be increasing in more recent years.

It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition is going to affect them.

A person should speak with a doctor if they experience any unusual symptoms. A doctor can help determine what underlying cause may be responsible for the symptoms.

The doctor will likely perform a physical examination and talk about the person’s medical and family history.

A person’s doctor may determine that they need to rule out cancer. For lung cancer, they may order tests, such as:

  • biopsy, which is the removal and examination of a small sample of tissue from the lungs
  • sputum cytology, which is an examination of the mucous from the lungs
  • imaging tests of the lungs, such as PET, MRI, CT scans, or X-rays
  • bronchoscopy, where a doctor inserts a tube to check for tumors or take a biopsy
  • thoracentesis, which is the examination of the lung’s fluids

There are several resources that can help a person or family member cope with receiving a cancer diagnosis.

The ACS offers several resources to help with a range of topics, including help with finding support groups. A person can review possible support group options on their website.

In addition, a person’s doctor or healthcare team may provide helpful information on where to find support groups and other resources.

A person should talk with a trusted member of their treatment team for help on finding resources that may work well for them.

Stage 2 lung cancer refers to a specific stage of NSCLC. The cancer at this stage has either not spread past the lungs or has only spread to the first level of surrounding lymph nodes.

Treatment involves a combination of surgery, chemotherapy, immunotherapy, targeted drug therapy, radiation, or a combination of these.

The 5-year relative survival rate for stage 2 lung cancer is 35–63%, though these numbers may continue to improve. A person may find it beneficial to find a support group to help cope with their cancer diagnosis.