What To Know about Stage 3 Lung Cancer

Lung cancer causes cancer cells to develop a tumor in the lungs' tissues. Lung cancer occurs in stages, and stage 3 occurs when cancer cells spread into other areas of the chest.

In the earlier stages, lung cancer may not cause noticeable symptoms. During stage 3, many people with the condition begin to experience symptoms like a chronic cough, shortness of breath, and fatigue.

About one-third of people with lung cancer are diagnosed at stage 3. Treatments at this stage can still help treat symptoms and improve your quality of life. Your exact treatment plan will depend on different factors but may include chemotherapy, radiation therapy, immunotherapy, and surgery. 

Types of Lung Cancer

There are several different types of lung cancer, typically categorized into two types: non-small cell and small cell lung cancer. Small cell lung cancer is the more aggressive, typically spreading beyond the lungs before diagnosis. About 80-85% of lung cancer cases are non-small cell lung cancer, and 10-15% of cases are due to small cell lung cancer. 

Stage 3 Lung Cancer Symptoms 

People with stage 3 lung cancer typically experience symptoms of the condition. This differs from people in stage 1 or 2, when symptoms may still be hard to notice. Symptoms can vary by person but may include:

• Chronic cough or coughing up blood
• Hoarse voice or voice changes
  
• Chest pain 
• Difficulty swallowing 
• Shortness of breath and wheezing
• Frequent respiratory infections 
• Fatigue 
• Loss of appetite 
• Unintended weight loss
• Swollen lymph nodes
  

Causes and Risk Factors for Lung Cancer

Lung cancer occurs when cells in the lung tissue mutate, grow, and spread at an out-of-control rate. The most common cause of lung cancer is smoking. Healthcare providers and researchers recommend avoiding or quitting smoking because tobacco use is the cause of 80% of all lung cancer deaths. 

Some people who don't have a history of smoking can also develop lung cancer, which indicates that several other risk factors for lung cancer exist. You may be at increased risk if you:

• Breathe in secondhand smoke (or smoke from someone else's tobacco use)
• Come into contact with radon (a radioactive gas found in soil and rocks) that can seep into your homes or workplaces
• Work in mines, textile plants, or shipyards, which can increase the risk of asbestos exposure
• Make contact with harmful chemicals like arsenic, beryllium, or diesel exhaust
• Have a family history of lung cancer
• Receive radiation therapy for another type of cancer
• Live in a place with high levels of air pollution
• Take beta-carotene supplements in addition to tobacco use 
  

Diagnosis

If you're experiencing symptoms of lung cancer or may be at risk of the condition, it's important to see a healthcare provider for proper diagnosis. Your healthcare provider will likely start with a physical exam and medical history.

If needed, your provider will refer you to an oncologist (a medical doctor who specializes in diagnosing and treating cancer) for more support. Your healthcare team may also order additional tests, such as: 

• Blood tests: Measure the number of white blood cells, red blood cells, and platelets
• Sputum markers: Detect cancer tumor markers in the saliva and phlegm (coughed-up mucus)
• Lung biopsy: Examines a small sample of lung tissue under a microscope to look for cancer cells
• Bronchoscopy: Inspects the inside of the lungs using a small tube attached to a light and camera
• Chest X-ray: Takes images of the lungs and chest to check for abnormalities
• Magnetic resonance imaging (MRI): Uses imaging technology to view the lungs at several different angles and create detailed images of them
• Computed tomography (CT) scan: Locates the lung tumor and determines its size via imaging scans
• Positron emission tomography (PET) scan: Identifies cancer cells throughout the body via imaging and helps determine the cancer stage
  

Substages of Stage 3 Cancer

There are also different cancer substages within stage 3 lung cancer. These stages include:

• Stage 3A: Cancer cells have spread to the lymph nodes on the same side of the chest as the original tumor, but cancer cells have not spread to distant areas of the body
• Stage 3B: Cancer cells have spread to lymph nodes above the collarbone, lymph nodes on the opposite side of the chest, or the area between the lungs and heart
• Stage 3C: Cancer cells have spread to the chest wall or the membranes that surround the heart, and there may also be more than one cancerous tumor inside the lungs
  

Treatments for Stage 3 Lung Cancer

The treatment goal for stage 3 lung cancer depends on the cancer's progression and your symptom severity. The goal of treating stage 3A lung cancer is to remove the tumor and achieve remission. For lung cancer that has progressed significantly, treatments help slow the cancer's progression and promote comfort.

The most common treatments for lung cancer include:

• Chemotherapy: Uses drugs to shrink and kill cancer cells and may be offered as a primary treatment option before surgery
• Radiation therapy: Involves the use of high-energy beams to shrink the tumor and kill cancer cells
• Surgery: Removes the tumor and surrounding cancer cells

Other treatment options for stage 3 lung cancer may include:

• Immunotherapy: Boosts your immune system's response to the cancer cells, which can be done before or after surgery
• Targeted therapy: Identifies certain gene mutations and kills cancer cells
  

Is Prevention Possible?

It is not always possible to prevent stage 3 lung cancer. Because smoking is the most common risk factor, healthcare providers recommend avoiding or quitting smoking. Your risk of lung cancer can decrease by 30-60% after 10 years of no smoking. 

Some people can get lung cancer even without a history of smoking. Other prevention guidelines for stage 3 lung cancer include:

• Get screened for lung cancer, especially if you're at risk of the condition
• Seek diagnosis and treatment as soon as you develop symptoms
• Avoid areas with secondhand smoke
• Have your home tested for radon 
• Do not take beta-carotene supplements if you have a history of smoking
• Engage in daily exercise
• Eat a nutritious diet
• Manage stress via sleep, meditation, and hobbies you enjoy
  

Stage 3 Lung Cancer Survival Rates

The five-year survival rate for cancer refers to the percentage of people who are living five years after receiving a diagnosis. The survival rate depends on the cancer stage, type, and other factors. 

The five-year survival rate for stage 3 non-small cell lung cancer is 37%. Small cell lung cancer is often more aggressive, leading to a five-year survival rate of 18% for stage 3 (regional spread) small cell lung cancer. 

Living With Cancer

Living with cancer can be very challenging—and however you feel about your diagnosis is valid and okay. Remember that your healthcare team and loved ones are there to support you whenever you need it.

Getting a cancer diagnosis at a later stage can seem daunting, but treatments can help slow cancer progression and improve your symptoms. Remission of stage 3 lung cancer isn't always possible, and your exact prognosis will depend on factors like the type of lung cancer you have, your symptoms, and your overall health.

When things start to feel tough, it's also important to remember that taking care of your mental health is just as important as your physical health.

Rely on your family and friends for support, keep in contact with your healthcare team about your treatment, join a support group with other people living with cancer, and reach out to a mental health professional for additional care.