Lung cancer is a disease where there is cancerous growth in the tissues of the lungs. Non small cell lung
cancer is a type of cancer where tissues of the lung develop malignant cancer cells. At least 80% of the lung
cancer cases in United States are said to be that of non small cell lung cancer. The term non small cell lung
cancer is used for the different bronchogenic carcinomas that include adenocarcinoma, squamous cell carcinoma
and large cell undifferentiated carcinoma. Each of these types of non small cell lung cancer spreads and grows
in different ways. In the following article, we shall learn about non small cell lung cancer
stages and types.
Types of Non Small Cell Lung Cancer
Squamous Cell Carcinoma:
The cancer of the squamous cells is called squamous cell
carcinoma or epidermoid carcinoma. This cancer begins in the bronchial tubes and is usually detected after
patients cough up blood.
Cancer of the cells in lining alveoli is called the adenocarcinoma. It
is the most common type of non small cell lung cancer. It is seen in non-smokers, especially in women. The
cancer may be detected after a very long time after onset.
Large Cell Carcinoma:
Cancer in the different large cells is called large cell
carcinoma of the lung. This is a less common type of cancer that is seen only on 10% of patients with non small
cell lung cancer.
The less aggressive sub-type of adenocarcinoma is
bronchiolo-alveolar carcinoma. This cancer is seen to affect the small air sacs of the lungs.
Stages of Non Small Cell Lung Cancer
Non small cell lung cancer staging is very important in assessment, treatment and prognosis of this disease.
There are basically four different stages of lung cancer. Let us go into the details of non small cell lung
cancer staging in the following paragraphs.
Non Small Cell Lung Cancer Stage 1:
The earliest stage of non small cell lung cancer is stage 1. Stage 1
non small cell lung cancer prognosis is definitely good with the long term survival rate being better than any
other stage. Stage 1 is divided into stage 1A and stage 1B.
Stage 1 A:
In this stage, the tumor detected is less than 1½ inches or 3 centimeters in
Stage 1 B:
The tumor has grown to a size that is greater than 1½ inches.
The early symptoms of lung cancer are often asymptomatic and the tumor is detected during an X-ray for some
other health concern. Other common signs and symptoms of non small cell lung cancer stage 1 is persistent
cough, recurrent bouts of pneumonia and bronchitis. The treatment for small cell lung cancer stage 1 is usually
surgery. If surgery is not possible due to the location of tumor, radiation therapy is opted for. However,
chemotherapy or radiation therapy is not the line of treatment opted for when it comes to stage 1 A cancer.
Stereotactic body radiotherapy (SBRT) is usually carried out for those who cannot undergo surgery. Video
assisted throracoscopic surgery (VATS) is a less invasive technique that is carried out for treatment of non
small cell lung cancer. Stage 1 non small cell lung cancer
prognosis is most often very good. There is a 60 to 80% survival rate for
a 5 year period. Early detection and screening has shown a 90% survival rate in patients with stage 1 non
small cell lung cancer.
Non Small Cell Lung Cancer Stage 2:
The second non small cell lung cancer staging is usually defined as
localized cancer that is present within the lung and spreads to local lymph nodes. The long-term non small cell
lung cancer prognosis for stage 2 is definitely better than the later stages. The cancer may or may not have
spread to the lymph nodes and the tumor may be greater in size than 3 cm. It is usually located in the main
bronchus or invading the lining of the lungs. Stage 2 is also divided into stage 2 A and stage 2 B.
Stage 2 A:
The tumor is less than 3 cm in size but has spread to the local lymph
Stage 2 B:
The tumor in stage 2 B is larger than 3 cm and has spread to lymph nodes and
may be located in the bronchus or pleura.
The symptoms of stage 2 non small cell lung cancer include persistent cough, hemoptysis, that is coughing up
blood, shortness of breath, recurrent bouts of pneumonia and bronchitis. The stage 2 non small cell lung cancer
treatment includes surgery. After, the surgery the doctor may advice adjuvant chemotherapy that helps in
removal of any cancerous cells remaining after the surgery. Patients who cannot undergo surgery for any reason,
may be treated using radiation therapy. The survival rate for stage 2 is 40 to 50% and it may vary according to
the individual's health.
Non Small Cell Lung Cancer Stage 3 A: T
his is a locally advanced cancer, which is characterized by non
small cell lung cancer stage 3 A. This means the tumor may not have spread to other parts of the body but has
spread to lymph nodes on the same side of the body. The tumors in this stage are larger and spread to lymph
nodes on the same side of the body but at a distance to each other. The stage 3A non small cell lung cancer is
divided into different types according to the TNM system. Here, 'T' stands for tumor, 'N' stands for nodes and
'M' stands for metastatic disease.
The tumor is less than 3 cm in size and spreads to the lymph nodes that are on
same side but away from each other. It also means there is no metastases.
The tumor is larger than 3 cm and spreads to the lymph nodes that are on same
side but away from each other. It also means there is no metastases.
The tumor can be of any size and is near the airway or has spread locally to
the chest wall or diaphragm. Nearby lymph nodes are affected and no metastases.
The tumor can be of any size and is near the airway or may spread locally to
the chest wall or diaphragm. Nearby lymph nodes are affected that are present on the same side with no
The symptoms of stage 3A non small cell lung cancer include persistent cough, shortness of breath and recurrent
pneumonia or bronchitis infections. If the cancer has spread to the diaphragm or chest wall, it may cause chest
pain, rib pain, shoulder pain and back pain. One may also have hemoptysis, wheezing and hoarseness of voice as
a symptom. The treatment of stage 3A is generally surgery for tumor removal, adjuvant chemotherapy, or
combination chemotherapy. Radiotherapy is considered for those who cannot undergo surgery or tolerate
chemotherapy. Stage 3A non small cell lung cancer prognosis is poor and survival rate for a 5 year period is
just about 20 to 25%.
Non Small Cell Lung Cancer Stage 3 B:
Advanced lung cancer is non small cell lung cancer stage 4. The
size of the tumor may be very large and it may spread to distant lymph nodes as well as other organs in the
chest. It may also be a malignant pleural effusion, that is, fluid filling up between cancer cells and the
layers of cells in the lungs lining. Stage 4 non small cell lung cancer is divided according to the TNM system
Any T, N3, M0:
The tumor may be of any size spreading to the lymph nodes on the other
side of the chest, to the collarbone nodes or neck muscles. The tumor may not spread to other parts of the
T4, Any N, M0:
The tumor is of any size, located in the airways, invading local organs
like esophagus or heart, or has malignant pleural effusion. The nodes may or may not be affected and if
affected, may be near the tumor or away in the chest or neck. The tumor has not yet spread to other parts of
The symptoms of stage 3B include persistent cough, shortness of breath, hemoptysis, dysphagia, hoarseness of
voice. In case of pleural effusion, there may be chest pain and rib pain along with the general symptoms of
fatigue and weight loss. Non small cell lung cancer stage 3B is incurable but treatable. This stage is said to
be inoperable and the treatment includes chemotherapy and radiation therapy. Stage 3 non small cell
prognosis is only about 4% and the patient has roughly about 13 to 14
months of survival after treatment.
Non Small Cell Lung Cancer Stage 4:
Non small cell lung cancer stage 4, or metastatic lung cancer is the
most advanced type of lung cancer. The tumor has metastasized to other parts of the body or to another lobe of
the lung. The final stage lung cancer is described as T (any), N (any), M1
according to TNM system.
This means the tumor is of any size, with or without lymph nodes involvement and has metastasized to other
parts of the body or another lung lobe.
The symptoms may include persistent cough, hemoptysis, hoarseness, shortness of breath, chest pain, back pain,
wheezing, recurrent pneumonia or bronchitis. The cancer that spreads to other organs may lead to symptoms like
difficulty in swallowing if it spreads to the esophagus, along with symptoms like headaches, weakness and
seizures in case of brain and hip pain, rib pain or back pain if it spreads to the bones. The general symptoms
include fatigue, weight loss and loss of appetite. This inoperable stage is treated with chemotherapy,
radiation therapy and newer targeted therapies. Non small cell lung cancer stage 4 prognosis is less than 10%
and the lung cancer survival
rate for these patients is less than 8 or 9 months.
This was all about non small cell lung cancer staging and prognosis. If one learns that one suffers from lung
cancer, it is better to speak to your doctor about any doubts or questions in your mind. You can consider
joining a support group or can speak about your feelings with your loved ones. One should always stay positive
and follow the treatment advice of the doctor. Hope the above paragraphs have helped you understand the details
regarding non small cell lung cancer prognosis and treatment