Stage 3 Cancer: Definition, Diagnosis, Treatment, Prognosis
Outlook And Life Expectancy For Non-Small Cell Lung Carcinoma
Non-small cell lung carcinoma (NSCLC), also called non-small cell lung cancer, is the most common type of lung cancer. "Non-small cell" refers to the way cancer cells look under a microscope.
If the cells look small, the cancer is referred to as small-cell lung cancer (SCLC).
According to the American Cancer Society, about 80–85% of all lung carcinomas fall into the non-small cell category. NSCLC doesn't tend to spread as fast as SCLC and has a better survival rate.
The majority of people with early-stage NSCLC survive at least 5 years, but the survival rate is much lower if the cancer has spread to other tissues at the time of diagnosis.
In this article, we review the survival rates and outlook for NSCLC.
A 5-year survival rate is the percentage of people with a certain cancer who are still alive 5 years after their diagnosis. For example, if 90% of people with a certain type of cancer are alive 5 years later, the 5-year survival rate would be 90%.
The 5-year survival rate is commonly used to measure a cancer's deadliness. Cancer is most likely to return within 5 years, so many sources include a 5-year survival rate in their statistics. You may also see some sources list 1-, 2-, or 3-year survival rates.
Another common statistic used to measure cancer outlook is the 5-year relative survival rate. A 5-year relative survival rate compares the survival rate of people with certain cancers with the survival rate of the general population in the same period. It aims to show how much cancer lowers lifespan.
For example, a 95% 5-year relative survival rate means that people with a disease are 95% as likely to be alive after 5 years than people without the disease.
The average survival rate for NSCLC is higher than the average survival rate for SCLC. According to the American Cancer Society, the 5-year relative survival rate for all stages is around 28%.
Numerous factors influence your chances of survival, such as:
Survival rates can give you a rough idea of what to expect. However, your medical care team can give you a better idea of your outlook.
Here's a look at how the 5-year relative survival rate changes by cancer stage:
Lung cancer survival rates are continuing to rise, and it's possible that the actual survival rates are higher than the statistical rates based on past data.
Here are some commonly asked questions people have about NSCLC:
Can NSCLC spread?NSCLC can spread to other parts of your body if left untreated or if treatment fails, including the lymph nodes, adrenal glands, liver, bones, or brain.
NSCLC that has spread to nearby lymph nodes is called stage 2B lung cancer. NSCLC that has spread to nearby areas is known as stage 3 cancer, and NSCLC that has spread to more than one area outside your lungs is known as stage 4 cancer.
Is NSCLC treatable?NSCLC is treatable, especially if treatment starts before the cancer spreads to other body parts.
If the cancer is limited to a small part of your lungs, it may be treatable with surgery alone. A more advanced cancer may require additional treatments. According to the National Cancer Institute, nine types of standard treatments are used for NSCLC:
Radiosensitizers and new combinations of treatment are currently being investigated in clinical trials.
Is NSCLC slow-growing?NSCLC tends to grow slower than SCLC and has a better outlook. A 2019 study found that the median cell doubling time for NSCLC was 230 days. By contrast, a 2020 review estimated the average cell doubling time in SCLC to be 86 days.
Doubling time is a prognostic marker that assesses how quickly cancer cells take to double in size.
However, the speed at which it progresses varies between people, can be influenced by many factors, and has many potential prognostic markers. As a result, it can be challenging to accurately predict the progression of NSCLC.
NSCLC is the most common type of lung cancer. The outlook of NSCLC is best when it's caught before it spreads beyond your lungs. Nearly two-thirds of people with early-stage lung cancer survive at least 5 years.
Advanced NSCLC has a lower survival rate. If the cancer has spread to nearby tissues, the chance of surviving at least 5 years drops to about 1 in 3, and if it has spread to distant tissue, the chance drops to less than 1 in 10.
NSCLC treatment is continuing to improve, and NSCLC survival rates will likely continue to rise over time. Your healthcare team can help you develop a treatment plan and alert you of any clinical trials that you may be eligible for.
What To Know About Life Expectancy For Recurrent Small Cell Lung Cancer
Most people with small cell lung cancer will have a recurrence. While several factors affect life expectancy, the outlook is typically less favorable. Treatment for recurrent small cell lung cancer is typically palliative.
Lung cancer is the second most common type of cancer and the leading cause of cancer death in both men and women in the United States. The American Cancer Society estimates that in the United States, in 2024, there will be 234,580 new diagnoses of lung cancer.
Small cell lung cancer (SCLC) makes up roughly 15% of lung cancer diagnoses and is more aggressive than other types of lung cancer. That means it's more likely to grow and spread quickly and can come back (recur) after treatment.
To learn more about recurrent SCLC and its outlook, please continue reading.
Learn more about small cell lung cancer.
Recurrent SCLC is cancer that comes back after treatment. It happens when a small number of cancer cells survive treatment. These cells may not show up on follow-up testing but can eventually grow to form a new, detectable tumor.
According to the National Cancer Institute, most cancers will recur within 5 years. However, according to a 2020 study, over 90% of SCLCs recurred within 2 years.
SCLC can recur in different ways:
The life expectancy of recurrent SCLC can vary based on its stage. The table below shows the five-year survival rates of each stage of SCLC between the years 2012 and 2018.
Life expectancy for each stage of SCLCDoctors can also use a two-stage system for recurrent SCLC:
A 2018 review notes that the median overall survival is 20 months for limited-stage SCLC and 8–12 months for extensive-stage SCLC.
Age can also play a role in the outlook for SCLC. Generally speaking, people ages 65 years and older can have a negative effect on their outlook because of their age.
One 2021 study of individuals with SCLC suggests that the average age at diagnosis was 66 years. Most people in the study experienced a recurrence of their SCLC.
The table below shows the median survival time and the one- and three-year survival rates based on age, according to a 2022 study in people with SCLC.
Survival times for SCLCSCLC is often very aggressive and challenging to treat. Because of this, it is very unlikely to cure recurrent SLCC.
A 2018 commentary notes that doctors consider recurrent SCLC to be incurable and that they prescribe the treatment with palliative intent.
Palliative therapy is treatment aimed at improving quality of life and reducing symptoms. It may shrink or slow the growth of the cancer, but it cannot cure it.
Doctors determine the stage of your recurrent cancer in the same way as staging at your initial SCLC diagnosis. Your doctor will use imaging and laboratory tests to determine the extent of your recurrent SCLC.
Your doctor will then develop a treatment plan for your recurrent SCLC. This depends on several factors, including:
Several factors can affect survival and outlook for recurrent SCLC. These include:
It's important to remember that each person with cancer is different. Your care team can consider all of the factors above to give you a better idea of your outlook and what to expect.
How do you treat recurrent small cell lung cancer?Doctors treat recurrent SCLC with chemo with or without immunotherapy. The specific type of chemo they use depends on which chemo drugs that cancer is sensitive to. They may also use radiation therapy as a palliative treatment.
It's also possible that your care team may recommend that you participate in a clinical trial testing new or updated ways to treat recurrent SCLC.
Can you prevent small cell lung cancer from coming back?There's no surefire way to prevent SCLC from coming back. Most SCLCs will recur.
If surgery was part of your initial treatment, you may have adjuvant therapy to destroy the remaining cancer cells and help prevent the cancer from coming back. You can also improve your overall health after treatment by making lifestyle changes like:
Is recurrent small cell lung cancer terminal?SCLC is typically terminal. A cancer is terminal when it cannot be managed or cured using treatment and will eventually lead to death.
Is small cell lung cancer the worst kind of lung cancer?There are two general types of lung cancer, SCLC and non-small cell lung cancer (NSCLC). SCLC is more aggressive and has a less favorable outlook than NSCLC.
SCLC is an aggressive type of lung cancer. Many people who have this type of lung cancer will experience a recurrence, typically within 2 years of diagnosis.
Because it's aggressive and often resistant to first-line treatments, recurrent SCLC has an unfavorable outlook. The treatment that you receive for recurrent SCLC is typically palliative.
The extent of SCLC and age are two important factors affecting your outlook. Other factors affecting recurrent SCLC outlook include how the cancer responds to treatment, your performance status, and your overall health.
If you receive a diagnosis of recurrent SCLC, have an open discussion with your care team about your outlook. They can give you a better idea of what to expect.
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