Stage-3 Lung Cancer - All You Need to Know

Introduction

A condition where the cells in the lungs proliferate uncontrollably is called lung cancer. Lung cancer is diagnosed in stage three in most cases. Studies show that about thirty-five percent of people suffering from lung cancer are diagnosed at stage 3. In stage three lung cancer, the cancer will spread to the nearby tissues. Lung cancer is the third most common type of cancer seen in the United States.

What Is Stage-3 Lung Cancer?

The general definition of stage-3 is when the cancer has spread to the areas of nearby tissues. There are three further substages in stage-3 that provide more details about the cancer’s progression. The symptoms of lung cancer like cough, shortness of breath, hoarseness, headache, etc., can often be confused for lesser serious conditions. This is another reason why lung cancer is often diagnosed in stage three in about thirty-five percent of cases.

How Is Stage-3 Lung Cancer Staged Further?

Stage-3 is when the lung cancer has spread to the adjacent areas near the primary tumor. Stage three is further divided into smaller categories, describing how far and how much the cancer has spread. Generally, TNM staging is used to categorize the stages of cancer. The size of the tumor is marked as T, N refers to the involvement of lymph nodes and M represents the spread of the cancer. In stage three, the cancer has spread to the nearby areas or distant lymph nodes. Stage three lung cancer is further subdivided into stages 3A, 3B, and 3C.

1. Stage 3A: In this stage, the cancer is considered locally advanced. The cancer cells have spread to the lymph nodes on the same side of the chest as the primary tumor. However, it has not traveled to distant areas in the body. It may affect the major bronchus, the lining of the lung, the chest wall, the diaphragm, or the membrane that surrounds the heart. The trachea, the esophagus, the nerve controlling the voice box, the chest bone or backbone, or the carina - the region where the trachea joins the bronchi may all experience metastases. Stage 3A is further divided as:

• T1N2M0: The size of the tumor is less than 3 cm (centimeter) and has spread to the lymph nodes away from the primary tumor but on the same side.

• T2N2M0: The size of the tumor is more than 3 cm, but less than 5 cm. It has spread to the lymph nodes away from the primary tumor but on the same side.

• T3N1M0: The size of the tumor is more than 5 cm. It has spread locally to an area like the chest wall or the pericardium. The lymph nodes in the nearby areas are affected.

• T3N2M0: The tumor may be of any size but is close to the airway or has locally spread to the chest wall or the diaphragm. The lymph nodes far away from the primary tumor (but on the same side) are affected.

• T4N0M0: The tumor is more than 7 cm in size, or has locally metastasized to the mediastinum or the diaphragm. However, there is no involvement of the lymph nodes.

• T4N1M0: The tumor is more than 7 cm in size or has locally metastasized to the mediastinum or the diaphragm, along with the involvement of the lymph nodes far away, but on the same side as the primary tumor.

2. Stage 3B:

• Any T, N3, M0: A tumor of any size that has spread to lymph nodes on the opposite side of the chest from the primary tumor, lymph nodes close to the collarbone, or nodes near the neck muscles. The distant parts of the body are not affected.
• T3 or T4, N2M0: The tumor is either huge in size (more than 5 cm), or has invaded nearby structures. It has spread to nodes farther away but on the same side of the chest.

3. Stage 3C:

• T3N3M0: The size of the tumor is between 3 cm and 5 cm. There are at least two distinct tumors in one lobe of the affected lung or it has spread into the tissues surrounding the heart or the lining of the chest wall. The distant parts of the body, however, remain unaffected.

• T4N3M0: The tumor is larger than 7 cm, or there are at least two tumors in distinct lobes of the affected lung, or the tumor has spread to neighboring structures like the trachea or esophagus. Remote areas of the body remain unaffected.

What Are the Symptoms of Stage-3 Lung Cancer?

The symptoms of stage-3 may vary from person to person. However, the common symptoms include:

• Persistent cough.

• Fatigue.

• Breathing difficulty.

• Unexplained weight loss.

• Repeated infections like pneumonia or bronchitis.

• If spread to areas like the chest wall and diaphragm, it causes pain in the chest, ribs, shoulders, or back.

• If the tumor has spread to the airways, it can cause hemoptysis (coughing of blood) and wheezing.

• If the tumor affects other organs like the esophagus or the other parts of the chest, there can be symptoms like dysphagia (difficulty in swallowing), or hoarseness of voice.

• If pleural effusion (accumulation of fluid in the tissues lining the chest) is present, pain in the back, chest, and ribs can be present.

How Is Stage-3 Lung Cancer Treated?

The management of stage-3 lung cancer varies among professionals mainly because of the variations in each type. A combination of chemotherapy and radiotherapy is advised for relatively healthy people. However, if the individual is unable to tolerate chemotherapy, radiation therapy alone is used to manage symptoms like pain and difficulty breathing.

• Targeted Therapy: Medications that are targeted to destroy the cancer cells specifically are used in targeted therapy. They are usually less harmful to the normal cells. They are also called molecularly targeted drugs or precision medicine. They generally work by preventing the growth of the tumor cells.

• Immunotherapy: This treatment initiates the body’s immune system to fight the cancer cells. However, studies show that this treatment might not work for everyone in the same way - some people might find it ineffective, a group may have some negative impacts, while some might be completely cured.

• Surgery: It offers a chance for a cure. However, the size of the tumor and the extent of spread are two factors that determine if surgery will be effective. Surgery can be combined with chemotherapy in stage 3A. It still poses the risk of recurrence after surgical removal.

Conclusion

Stage-3 lung cancer is treatable. However, as every person is different, and responds differently to treatment, the success rate and recovery also will differ. Age and general health are two other factors that determine the recovery of the patient.