Is Stage 3 Lung Cancer Operable?

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Nearly a third of people diagnosed with non-small cell lung cancer (NSCLC) have stage 3 of the disease. In most cases, the cancer can’t be removed successfully through surgery. But “most” doesn’t mean “all,” and other powerful treatments are available. Having surgery doesn’t always equal having the best treatment. A key characteristic of stage 3 lung cancer is the variety of forms it can take. A critical component of your lung cancer care is a personalized treatment plan developed by a team of specialists.

What Is Your Stage 3 Lung Cancer Subtype?

Almost a quarter of a million people are estimated to be diagnosed with NSCLC this year. Lung cancer doctors stage NSCLC based on the size of your tumor and how far the cancer has spread. An important consideration is whether or not your lymph nodes are involved. Stage 3 lung cancer can mean one of these three things:

  • The tumor size is between five and seven centimeters.
  • There is more than one tumor in the same lobe of the lung. (The right lung has three lobes; the left lung has two.)
  • The cancer has spread to nerves close to the lungs, the cover of the heart (pericardium), or areas of the chest such as the ribs, diaphragm, or muscles.
Treating Advanced Lung Cancer

Once your lung cancer care team has evaluated all these factors, your stage 3 lung cancer will be further defined as sub-type A or B. This refinement helps inform treatment decisions, but it doesn’t dictate them. Remember, there’s a wide range of lung cancer scenarios , and your body is unique. Stage 3A lung NSCLC may be operable, but stage 3B is not.

Lung Cancer Treatment for Stage 3A Lung Cancer

In stage 3A NSCLC, the cancer has spread to specific lymph nodes near your lungs, but hasn’t spread to other parts of your body. Your treatment plan for stage 3A NSCLC may include:

  • Surgery
  • Radiation therapy
  • Targeted therapy, medicines that reach specific cells to stop cancer from growing or reduce the size of tumors
  • Immunotherapy (biologics), medicines that work with your body’s immune system to attack cancer cells

Lung cancer specialists often recommend beginning treatment with a combination of chemotherapy and radiation therapy. If any cancer remains and can be removed, surgery may be an option. In some cases, surgery is performed as a first step.

Types of surgery include:

  • Lobectomy, the removal of a lobe of the lung that is cancerous
  • Wedge resection or segmentectomy, two different types of procedures for removing part of a lobe when the entire lobe can’t be removed
  • Pneumonectomy, the removal of one entire lung, which may be necessary if a tumor is near the middle of your chest

Lung Cancer Treatment for Stage 3B Lung Cancer

In Stage 3B NSCLC, the cancer has spread to lymph nodes near your lungs or neck. It may also have spread to your chest. Surgical procedures can’t remove this cancer completely, so chemotherapy and radiation therapy are often used alone or in combination. These treatments may be able to kill cancer cells when surgery can’t. If they don’t, targeted therapy and immunotherapy offer additional options.

There are more non-surgical treatment alternatives for lung cancer today than ever before, research is ongoing, and survival rates are improving. Ask your doctor to keep you up-to-date and see if you’re eligible for clinical trials that test the latest treatments. All treatments, including surgery, come with benefits and risks. Look to your doctor to explain them, help you weigh them, and navigate the best way forward.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Jul 4
  1. Inoperable stage III non-small cell lung cancer: Current treatment and role of vinorelbine. US National Library of Medicine National Institutes of Health.
  2. Non-Small Cell Lung Cancer Treatment (PDQ®)–Health Professional Version. National Cancer Institute.
  3. Treatment Choices for Non-Small Cell Lung Cancer, by Stage. American Cancer Society.
  4. TNM Staging. Cancer Research UK.
  5. Chemotherapy for Non-Small Cell Lung Cancer. American Cancer Society.
  6. Targeted Therapy Drugs for Non-Small Cell Lung Cancer. American Cancer Society.
  7. Immunotherapy for Non-Small Cell Lung Cancer.
  8. 9 Things to Know About Immunotherapy and Lung Cancer. American Society of Clinical Oncology (ASCO).
  9. Lung Cancer – Non-Small Cell: Treatment Options.
  10. National Cancer Institute. Cancer Stat Facts: Lung and Bronchus Cancer.
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