What Is Stage III Lung Cancer?
Doctors use stages to describe how much cancer you have and where it is in your body. People with stage III lung cancer can be a very mixed group. Their tumors can differ in size, location, and how distant they are from where the cancer started.
But almost always, stage III cancer is in just one lung. It’s also limited to the lymph nodes, organs, and other tissue near that organ. The cancer has not spread, or metastasized, beyond that. That’s why this stage is also called locally advanced or locoregional disease.
The next stage, stage IV, is the last and most serious stage of lung cancer.
Stage III Lung Cancer Substages
Nearly 9 out of 10 people with lung cancer have non-small-cell lung cancer (NSCLC). A rarer and more aggressive type is called small-cell lung cancer. But the numbered stages are used mainly for the more common NSCLC.
Staging uses three key criteria called TNM:
- Tumor (T): How big and where is the tumor?
- Nodes (N): Is the cancer in nearby lymph nodes?
- Metastasis (M): How far has the cancer spread from its original spot?
Doctors split stage III non-small-cell lung cancer into three main subtypes. It helps them get a more detailed picture of your cancer and decide on the best treatments.
Stage IIIA. You have one or more tumors in one lung. The cancer is in nearby lymph nodes. The cancer may be in certain nearby tissues, but it hasn’t reached distant organs.
Stage IIIB. You have one or more tumors in the same lung. Your cancer may have spread to lymph nodes above your collarbone and may be in lymph nodes on the opposite side of your chest. The cancer may be in certain nearby tissues but not in distant organs.
Stage IIIC. This is the most advanced stage within stage III. You have one or more tumors in the same lung. Your cancer has spread to lymph nodes above your collarbone or to lymph nodes on the opposite side of your chest. The cancer may be in the chest wall, heart, breastbone, and other nearby tissues but hasn’t spread to distant organs.
Stage III Lung Cancer Symptoms
Most non-small-cell lung cancer is found after it’s become advanced. That’s partly because the disease worsens quickly and often doesn’t have signs in the early stages. But symptoms may include:
- A cough that won’t go away (the most common symptom)
- Weight loss
- Shortness of breath or wheezing
- Pain in the chest
- Coughing up blood or rust-colored spit
- A hoarse voice
If your stage III lung cancer has spread beyond your lungs, it can cause other symptoms. For example, you may have bone pain if it has spread to your bones.
Stage III Lung Cancer Diagnosis
Your doctor probably found your lung cancer after checking your symptoms. Most people aren’t routinely checked for the disease unless they smoke or otherwise face a higher risk.
A chest X-ray is often the first image test. If it suggests you have cancer, you’ll have follow-up tests, such as:
CT scan. Your doctor may order a "contrast-enhanced" version of this scan, which can take more detailed images.
Your doctor may run other tests to check the extent of your cancer. They might include:
- PET scan
- MRI
- Bone scan
Biopsy. A doctor will examine a sample of your tissue under a microscope to confirm that it’s cancer.
Stage III Lung Cancer Treatments
Your doctors have several ways to treat you based on the size, location, and other characteristics of your cancer, including:
- Chemotherapy. This drug therapy uses chemicals to kill and limit the growth of new cancer cells. You may get this after surgery to help suppress any future cancers.
- Radiation. Your doctor will use powerful radiation to destroy cancer cells. If surgery fails to take out all of the cancer, you may get radiation therapy, or you may have chemotherapy followed by radiation therapy.
- Chemoradiation. If surgery isn’t an option, you may get chemotherapy, radiation therapy, or both at the same time.
- Immunotherapy. This therapy uses drugs to rally your body’s immune system to fight the cancer. Your doctor may use immunotherapy as a first treatment if surgery isn’t a good choice, or use it after chemoradiation.
Stage III lung cancer surgery
If possible, your doctor may opt for an operation to remove all the tumors from your lungs. If your lung cancer has spread into your lymph nodes, they may not be able to remove all of it. Some surgical options include:
- Lobectomy. Your lungs are made of lobes, or sections. Your right lung is slightly larger, with three lobes, while the left has only two. During this surgery, the entire lobe containing the tumor will be removed.
- Wedge resection. This is when only part of a lobe is removed. Your doctor may refer to this surgery as a "segmentectomy."
Adjuvant therapy
After you have a primary treatment for your lung cancer, such as surgery, chemotherapy, or radiation, your health care team may recommend adjuvant therapy, or treatments that try to keep your cancer from coming back. Adjuvant therapy may include additional chemotherapy, targeted drug therapy, or immunotherapy. You may receive adjuvant therapy for a few weeks or up to 10 years, depending on your overall health and how likely it is for your cancer to come back.
Talk with your doctor to understand your treatment plan.
Stage III Lung Cancer Prognosis
More people in the U.S. die of lung cancer than of breast, colon, and prostate cancers combined. About 1 in 3 people diagnosed with stage IIIA lung cancer live for at least 5 years after their diagnosis. For stage IIIB, the average 5-year survival rate is 26%. For stage IIIC, it’s 13%.
Your long-term outlook may be better if you:
- Have lost less than 5% of your weight before starting treatment
- Are a woman or were assigned female at birth
- Do not have a lung infection, collapsed lung, or fluid buildup around the lung
- Have a type of cancer cell that responds well to certain treatments
Living With Stage III Lung Cancer
Any serious illness can bring worry, uncertainty, and other challenges to you and your loved ones. Try to:
Manage your pain. You may feel pain not only from your cancer but also from treatments as well. Work with your doctors to control your pain as well as you can. That also may help lower your chances of depression.
Ease other symptoms. Weight loss is common when you have cancer. Eat well to help keep up your strength and to prevent infections. For constant coughs, you might find relief with:
- Humidifier
- Deep-breathing exercises
- Different body positions to clear your airways
- A machine to clear mucus
Pulmonary rehab may also improve your symptoms and quality of life. It may help you breathe easier and stay more active.
Quit smoking. It’s never too late to stop. People who give up smoking before their cancer treatments tend to respond better. If it’s hard for you to quit, a smoking cessation program may help.
Connect with others. There is no such thing as too much support. It may help to talk to a medical social worker, mental health counselor, or other professionals. Join a cancer support group, either in person or online. Find out if any local groups offer free rides to appointments and other help. The American Cancer Society has a searchable directory of programs.
Lung Cancer Screening
If you've smoked heavily in the past, your doctor may recommend you get screened for lung cancer each year. Using a low-dose CT scan (LDCT), a type of noninvasive X-ray, your doctor can check for early signs of lung cancer before you even have symptoms.
You may be a candidate for yearly lung cancer screening if you:
- Are between 50 and 80 years old
- Smoke currently or quit in the last 15 years
- Have at least a "20-pack year" smoking history. You can determine your pack years by multiplying how many years you've smoked by how many packs of cigarettes you smoke(d) each day.
LDCT scans expose you to a small amount of radiation, which can increase your risk of cancer, but this test uses less radiation than a standard CT scan. The benefits of the scan typically outweigh its risks, as earlier stages of lung cancer are easier to treat if your doctor sees any early signs of cancer.
Takeaways
Stage III lung cancer is when you have cancer in one or more lobes, or sections, of one lung. Depending on how progressed it is, cancer at this stage may have also spread to nearby lymph nodes and tissue. The diagnosis is serious, but treatments for stage III lung cancer, including chemotherapy, radiation, and surgery, may be able to improve your outlook. If you smoke now or have smoked heavily in the last 15 years, talk with your doctor to see if you're a good candidate for yearly lung cancer screening.
Stage III Lung Cancer FAQs
Is stage III lung cancer terminal?
No. Everyone's cancer and response to treatment are different. However, therapies for stage III lung cancer are improving, and survival rates have gotten better in recent years.
How long can you live with stage III lung cancer?
Everyone's outlook is different, but on average, 15 in 100 people with stage III cancer will live 5 years after they've been diagnosed.
What is the most aggressive form of lung cancer?
Small cell lung cancer is the most aggressive form of the illness. It usually begins in the airways and can quickly spread to other parts of the body.
