Stage 3 lung cancer

There are three categories of stage 3 lung cancer. These are stage 3a, stage 3b and stage 3c.

If you have stage 3 lung cancer, it is likely that your cancer has spread to your lymph nodes. It was may also have spread to other parts of your lung, your airways and/or the surrounding areas outside of your lung. But it has not spread to other parts of your body.

Stage 3 lung cancer is often described as locally advanced lung cancer.

Stage 3a lung cancer means one or more of the following may have occurred:

• The tumour is between 3cm and 7cm+
• The cancer may have grown into the main airway (bronchus) of the lung
• The cancer has grown into the membrane (visceral pleura) covering the lung
• The cancer is blocking the airway or causes inflammation in the lung tissue, resulting in the lung partly or completely collapsing.
• The cancer may have spread to the lymph nodes where the windpipe divides (the carina) or the space between the lungs (mediastinum) on the same side as the cancer
• The cancer may have grown into your chest wall or its inner lining, the phrenic nerve (which is a nerve close to your lung), the diaphragm, a main blood vessel, the windpipe, your larynx, oesophagus, spinal bone or the layers of the sac that covers the heart (mediastinal pleura and parietal pericardium)
• There may be two or more areas of cancer in the same lobe of your lung
• The cancer has not spread to other parts of your body

Stage 3b lung cancer means one or more of the following may have occurred:

• The tumour is between 3cm and 7cm+
• The cancer may have grown into the main airway (bronchus) of the lung
• The cancer has grown into the membrane (visceral pleura) covering the lung
• The cancer is blocking the airway or causes inflammation in the lung tissue, resulting in the lung partly or completely collapsing.
• The cancer may have spread to the lymph nodes where the windpipe divides (the carina), in the space between the lungs (mediastinum) on the same side as the cancer or where the bronchus enters the lung (hilar lymph nodes) in the opposite lung
• The cancer has spread to lymph nodes in the side of the neck or above the collarbone
• The cancer may have grown into your chest wall or its inner lining, the phrenic nerve (which is a nerve close to your lung), the diaphragm, a main blood vessel, the windpipe, your larynx, oesophagus, spinal bone or the layers of the sac that covers the heart (mediastinal pleura and parietal pericardium)
• There may be two or more areas of cancer in the same lobe of your lung
• The cancer has not spread to other parts of your body

Stage 3c lung cancer means one or more of the following may have occurred:

• The tumour is between 5cm and 7cm+
• The cancer may have grown into your chest wall or its inner lining, the phrenic nerve (which is a nerve close to your lung), the diaphragm, a main blood vessel, the windpipe, your larynx, oesophagus, spinal bone or the layers of the sac that covers the heart (mediastinal pleura and parietal pericardium)
• There may be two or more areas of cancer in the same lobe of your lung
• The cancer may have spread to the lymph nodes in the space between the lungs (mediastinum) on the opposite side as the cancer or where the bronchus enters the lung (hilar lymph nodes) in the opposite lung
• The cancer has spread to lymph nodes in the side of the neck or above the collarbone
• The cancer may have spread to the lymph nodes where the windpipe divides (the carina), in the space between the lungs (mediastinum) on the same side as the cancer or where the bronchus enters the lung (hilar lymph nodes) in the opposite lung
• The cancer has not spread to other parts of your body.

Treatment for stage 3 lung cancer

There are different treatment options for stage 3 lung cancer. It is still possible to treat stage 3 lung cancer with curative intent.

Your treatment will depend on several factors including:

• The type of lung cancer you have (e.g. small cell lung cancer or non-small cell lung cancer)
• The position and size of your tumour
• Your general health and fitness.

Surgery

If you have stage 3 lung cancer and are considered in good health, you may be offered surgery to treat your lung cancer. This will depend on the size and location of your tumour.

If you are offered surgery, you may also may either chemotherapy or chemo and immunotherapy before you have your operation. The aim of this treatment is to shrink your tumour

If your doctors decide surgery is the best option for you, you will either have part of your lung removed (a lobectomy) or the whole of your lung removed (pneumonectomy). This will depend on the location of the tumour.

After you have recovered from surgery, your doctor may offer adjuvant treatment to reduce the chances of your cancer recurring. This might involve chemotherapy, chemo and immunotherapy, radiotherapy or a targeted therapy.

Nick’s story

Nick was diagnosed with stage 3b lung cancer. He underwent surgery to remove his tumour and then had adjuvant chemotherapy.

Twelve months after his treatment ended, Nick was able to scuba dive again and continues to dive without trouble.

Other treatments for stage 3 lung cancer

If surgery is not an option to treat your lung cancer, or you decide you don’t want to have an operation, there are other treatment options available. These includes:

• Radiotherapy
• Chemotherapy and radiotherapy (at the same time)
• Sequential chemotherapy and radiotherapy
• Immunotherapy.

Jane’s story

Jane was diagnosed with stage 3b lung cancer in 2014. A PET scan confirmed the cancer had spread to the lymph nodes in her neck and she was told her cancer was inoperable and incurable.

Jane had four cycles of chemotherapy. This had a limited effect, so her treatment was changed to 30 sessions of radical radiotherapy. By March 2015, Jane’s scans had revealed that the only active cancer remaining was in the main tumour in my right lung and she was able to then have surgery.

An avid runner, Jane is back running and was even interviewed by The Body Coach, Joe Wicks about her amazing experience.

After treatment for stage 3 lung cancer

After you have completed your treatment, you will have regularly follow up scans. Typically, after five years of clear scans, you will be discharged and require no further follow ups.