Treating Stage 3 Lung Cancer

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Stage 3 vs. Stage 4 Lung Cancer: Prognosis and Life Expectancy

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Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, and when it’s diagnosed, it’s given a stage from 1 to 4. Staging is based on the size of the tumor and whether the cancer has spread to your lymph nodes or other parts of your body. The stage of your cancer provides information about its extent—a higher number indicates a more serious case—and helps your doctor determine your treatment plan.

Approximately 80% of people with lung cancer are classified as stage 3 or stage 4 at the time of diagnosis. If you or a loved one fall into this group, you probably want to know what the future holds. While there’s a lot of variability from case to case, let’s try to shed some light on what you can expect.

Staying Strong With Lung Cancer

Understanding Stage 3 Lung Cancer

Stage 3 lung cancer is sometimes referred to as locally advanced lung cancer. It has not yet traveled to distant parts of your body, but it has spread to lymph nodes in the middle of your chest or grown into other nearby tissues.

When it comes to determining prognosis and life expectancy, we can turn to the numbers. The Surveillance, Epidemiology, and End Results (SEER) program maintains a database about cancer in the United States. It provides statistics about the 5-year relative survival rate for people with non-small cell lung cancer based on their stage at diagnosis. This is a percentage of how many people with a certain stage of lung cancer will be living in five years, compared to a similar group of people who don’t have cancer. According to the most recent data of this kind, if your lung cancer has spread to nearby regions of your body (stage 3), the 5-year relative survival rate is 30.8%. That means 30.8% of people with stage 3 lung cancer were still living five years after receiving a diagnosis.

It’s worth noting, however, that many new and promising treatments for lung cancer have been developed over the last several years, and these particular SEER numbers reflect information gathered between 1992 and 2016. It can be anticipated that the addition of new treatments, including targeted therapies and immunotherapy, will favorably extend the overall life expectancy and prognosis for late-stage lung cancer. Targeted therapy is a treatment that only works on certain elements of cancer cells and surrounding tissues to help stop cancer cells from growing and spreading. Immunotherapy helps specific immune system cells better identify and fight cancer cells. Both types of treatment have been shown to effectively treat lung cancer, helping patients live longer and with a higher quality of life.

The statistics in the SEER database reflect survival rates before many of these new lung cancer treatments emerged; in fact, the first immunotherapy drug approved by the Food and Drug Administration (FDA) was only granted that approval in late 2015. In a few years, we’ll have a much clearer idea of lung cancer prognosis now that newer treatments are part of the equation.

Understanding Stage 4 Lung Cancer

Stage 4 lung cancer is considered advanced, or metastatic, cancer. It may have spread to the other lung or further areas of the body, such as the brain, liver, or bones. Stage 4 lung cancer can’t be cured, but treatments are effective at extending life expectancy and improving quality of life. Based on the SEER database, people with stage 4 lung cancer have a 5.2% 5-year survival rate, which means historically, 5.2% of people with stage 4 lung cancer were alive five years after diagnosis. Of course, it’s important to keep in mind that new treatments are changing these statistics, and in a few years, the data will reflect these improvements. In the meantime, do your best to stay up to date with new treatment strategies and make sure you’re receiving emotional support, either from loved ones, mental health professionals, support groups, or all three. Studies show people who educate themselves and advocate for themselves during the cancer treatment process have better outcomes. 

Other Factors Affecting Prognosis of Lung Cancer

The stage of your cancer has an impact on your outcome, but other elements may also influence your lung cancer prognosis as well, including:

  • Overall health: Poor health or other medical conditions can impact your ability to tolerate or receive certain cancer treatments.

  • Performance factors: The ability to care for yourself and engage in physical activity is associated with better survival rates.

  • Smoking status: People who quit smoking often have longer survival times than those who continue to smoke after diagnosis.

  • Sex: Women tend to have better outcomes than men.

  • Weight loss: A weight loss of greater than 10% prior to starting cancer treatment is associated with a higher risk of cancer progression.

  • Tumor characteristics: Some genetic mutations or proteins found in cancer cells make them more receptive to certain cancer treatments.

It’s helpful to identify factors that can affect your lung cancer prognosis, but it doesn’t allow us to predict what will happen to any one individual. So, even though stage 3 and stage 4 lung cancer are challenging to treat, remember that your response to treatment is unique to you. And with advances in lung cancer therapies, the hope is you’ll be feeling better and living longer than statistics of the past. As always, talk to your doctor if you have any questions regarding your treatment plan and future outlook.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Jan 28
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