An unusual presentation of metastatic prostate cancer in a 44-year-old man: A case report and review of the literature
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.
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:
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.
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:
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.
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.
If you have symptoms of lung cancer, your doctor will likely order a chest X-ray to learn more. (Photo Credit: Stockbyte/Getty Images)
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:
Biopsy. A doctor will examine a sample of your tissue under a microscope to confirm that it's cancer.
Your doctors have several ways to treat you based on the size, location, and other characteristics of your cancer, including:
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:
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.
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:
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:
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.
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:
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.
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.
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.
A 37-year-old Nurse Got Unusually Short Of Breath On A Hike. She Had Stage 4 Lung Cancer.
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By clicking "Sign Up", you accept our Terms of Service and Privacy Policy. You can opt-out at any time by visiting our Preferences page or by clicking "unsubscribe" at the bottom of the email.On a hike in July 2020, Tiffany Job found herself incredibly short of breath.
"I couldn't go 20 yards without my heart rate shooting up," she told The Patient Story.
This was unusual for Job, 41, from Texas. "I maintained a healthy diet. I exercised constantly. As a Registered Nurse and part‐time pilates instructor, I was more proactive than most when it came to managing my own health and well-being," she wrote on the website of her nonprofit, Ten for Ten Million.
Then, that August she developed a cough that wouldn't go away after antibiotic and steroid treatments, so she went to see a primary care doctor who was a family friend.
Pulmonary function tests showed that Job had the lung capacity of an 80-year-old. The doctor thought she might have COVID, tuberculosis, or a fungus in her lungs.
But months after her symptoms began, Job was diagnosed with stage four lung cancer at age 37, despite being young, fit, and having never smoked.
Job first noticed her lungs weren't working normally while on a hike with her husband and twin sons. Captured by KLCLung cancer is rare in people under 45, with most patients diagnosed aged 65 and over, according to the American Cancer Society. Although CDC data suggests rates of cigarette smoking, which is the leading risk factor for lung cancer in the US, have declined significantly over the last few decades, rates of non-smokers getting lung cancer are rising.
Women who have never smoked in particular are more than twice as likely to develop lung cancer than men who have not smoked, and more of the few young people who get lung cancer have never smoked, a study published earlier this year in the journal Nature Reviews Clinical Oncology found.
Researchers don't know why this is, but it could be linked to certain gene mutations, such as EGFR, which can cause cells to grow out of control and lead to cancer.
Job was diagnosed with lung cancer after switching hospitalsIn October 2020, Job underwent a series of tests including a bronchoscopy, where a tube is fed down the throat into the lungs so doctors can see inside.
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"Every doctor known to man" tried to figure out what was wrong, she said.
After four days of "tests and treatments and poking and prodding," Job was diagnosed with cancer, but said she was told she'd have to wait up to 14 days for the results of a biopsy to reveal what type.
Job and her husband drove four hours to the University of Texas MD Anderson Cancer Center for a second opinion. Doctors quickly identified she had stage four, non-small cell lung cancer, which had spread to her pelvis, right femur, and cervical spine. She needed to start treatment right away.
Job and her husband drove to the MD Anderson Cancer Center for her treatments. Captured by KLC A trial treatment helped at firstJob found out that she had the EGFR gene mutation, which made her eligible for a clinical trial of an experimental lung cancer treatment starting in late 2020.
By November 2021, she was feeling like herself again — she hadn't needed supplemental oxygen since March, and was able to run a mile a day.
But in September 2022, her chest started to cramp again. By Thanksgiving, it had gotten so painful and frequent that she went to the ER, where she was told the cancer had gotten "worse," and the drugs were losing their effectiveness.
So, she started a new clinical trial in the second week of December 2022.
In November 2023, Job shared on Instagram that her primary tumor was growing, and her treatment was no longer effective. So, in December 2023, she started another round of chemotherapy and "initially had a great response," she told Business Insider.
Job's treatment is still ongoing as of September 2024. Captured by KLC Job's journey with cancer is ongoingBy July of this year, Job said she was no longer responding to the chemotherapy, and her tumor had started growing again.
In a post on Thursday, she wrote on Instagram that she hoped other drugs would be effective.
"My cancer diagnosis does not define me. I refuse to let it. But it does drive me. It drives me to be a better person and a more present mom and wife. And it drives me to share the hope I feel every day, not just with those who are fighting for their lives, but with those who soon will be," Job wrote on her non-profit's website.
She and her husband started Ten for Ten Million to raise funds for research at the MD Anderson Cancer Center. They told The Patient Story it gives them purpose and has allowed Job to leave an impression on the world.
The couple tries to make every day count, making sure to plan trips and have things to look forward to.
"You always think, 'Oh, when I retire, I'll go do this.' Well, that isn't going to happen for everybody. We don't know what's going to happen to us by the end of the day. We may as well just live for each and every moment," Job said.
Thyroid Cancer
Thyroid cancer is a type of cancer that starts in your thyroid gland. A gland is an organ in your body that makes a substance.
Your thyroid is shaped like a small butterfly and is found inside the lower front of your neck. It has two lobes, or pieces, one on either side of your windpipe, joined by a band of tissue called the isthmus.
Your thyroid gland is shaped like a butterfly and has two lobes. (Photo Credit: iStock/Getty Images)
Your thyroid controls your metabolism. It also makes and releases hormones that direct many functions in your body, including how you use energy, how you produce heat, and how you consume oxygen.
Thyroid cancer develops when abnormal cells change or mutate in the tissues of your thyroid gland. The abnormal (cancer) cells begin multiplying and, once there are enough of them, they form a tumor or mass in your thyroid.
If it's caught early, thyroid cancer is one of the most treatable forms of cancer.
Researchers have identified four main types:
Papillary thyroid cancer
If you have thyroid cancer, you probably have this type. It's responsible for 80% of all thyroid cancer cases. It tends to grow slowly, but often spreads to the lymph nodes in your neck. Lymph nodes act like filters to rid your body of foreign matter like cancer cells and infections. They clean fluid that comes from body tissues before it moves through the lymphatic system, part of your immune system. Even if the cancer has spread to your lymph nodes, you have a very good chance of a full recovery.
Follicular thyroid cancer
This makes up between 10% and 15% of all thyroid cancers in the United States. It can spread into your lymph nodes and is also more likely to spread into your blood vessels. The chance of recovery, if you have this type, is good but slightly less than if you have papillary.
Medullary thyroid cancer
This makes up about 4% of all thyroid cancer cases. If you have this kind, it's likely to be found at an early stage because it produces a hormone called calcitonin, which doctors keep an eye out for in blood test results.
Anaplastic thyroid cancer
This is usually the most severe type, because it's aggressive in spreading to other parts of the body. It's also rare (about 2% of thyroid cancer cases) and the hardest to treat.
Cancers are often described as well-differentiated or undifferentiated. Well-differentiated cancer cells have specialized structures and tend to grow and spread slowly. Papillary and follicular thyroid cancers are well-differentiated.
Undifferentiated cancers are the opposite. They don't have specialized structures and tend to grow and spread quickly. Medullary and anaplastic thyroid cancers are undifferentiated.
Thyroid cancer is rare. It made up just 2.2% of all new cancer cases in 2024.
In the beginning you may not notice any symptoms of thyroid cancer. But as it grows, you could notice any of the following problems:
Many of these symptoms may be signs of conditions that aren't cancer, but you should still see a doctor to be sure. Most thyroid cancers are found early when people go to their doctors about a swelling in their neck.
A swelling in the neck can be a sign of thyroid cancer. (Photo Credit: iStock/Getty Images)
The staging system most often used is the AJCC (American Joint Committee on Cancer)TNM system. It is based on three pieces of information:
T (tumor). How large is the tumor? Has it invaded nearby tissues?
T0 means no evidence of a tumor. T1-T4 is a progression, with T4 indicating the largest and most invasive tumor.
N (nodes). Has the cancer spread to nearby lymph nodes?
N0 means the cancer hasn't spread to lymph nodes. N1-N3 is a progression for how far the cancer has spread, with N3 being the biggest spread.
M (metastasis). Has the cancer metastasized (spread) to distant organs, like the lungs or the liver?
M0 means the cancer hasn't spread to distant organs. M1 means there is evidence of spread to distant organs.
Within these categories, there are subsections. For instance, M1b means the cancer spread to 2 or more organs.
Your doctor determines your TNM categories from looking at test results (blood tests, X-rays, etc.) and from physically examining you. Once your TNM categories have been decided, the next step is your staging. Cancer stages run from I to IV. The lower the number, the less your cancer has spread. Here's a simplified version of thyroid cancer stages:
Some doctors use a letter along with a stage. For instance, they might say your cancer is stage IIIA. The four letters are A, B, C and D. This tells you how fast-growing (aggressive) your cancer is. A is the least aggressive and D is the most aggressive.
Most people who get thyroid cancer get it through acquired gene mutation. This means the gene mutation happened randomly in their lifetime. For instance, half of all papillary thyroid cancers are caused by changes to the BRAF gene in your body, but this isn't something you can control.
Just a few things raise your odds of getting thyroid cancer:
Inherited genetic syndromes. Some conditions, including cancer, come from the DNA you get from your parents. In 2 out of 10 cases of medullary thyroid cancer (MTC), for example, the cancer is a result of an abnormal gene you've inherited.
Iodine deficiency. If you don't get much of this chemical element in your diet, you could be at more risk for certain types of thyroid cancer. This is rare in the U.S. Because iodine is added to salt and other foods.
Radiation exposure. If your head or neck was exposed to radiation treatment as a child, you could have a higher cancer risk.
There isn't a screening test for thyroid cancer. Your doctor may find out you have it during a routine physical exam or from an ultrasound or surgery for another condition.
Risk factors for thyroid cancer include:
Thyroid cancer is usually very treatable, even if you have a more advanced stage of it. The sort of treatment you get depends on the type of thyroid cancer you have and the stage it is at. Here are some common methods of treatment:
Surgery
This is part of treatment for nearly all types of thyroid cancer. You might have a thyroidectomy (a removal of your thyroid), which means you'll have to take thyroid hormone pills for the rest of your life. Or you might get a lobectomy (removal of one of your thyroid lobes if just one is cancerous). If so, you may not need to take thyroid hormones.
Your lymph nodes might also need to be removed surgically if the cancer has spread there.
Radiation therapy
This is often given after surgery to make sure the cancer doesn't return or to kill cells your surgeon may not have removed. You may get radiation therapy in a few ways:
Chemotherapy
Drugs to kill cancer cells are given either by mouth or as a shot. This isn't often needed when you have thyroid cancer.
Hormone Therapy
Taking high doses of the thyroid hormone can slow the growth of thyroid cancer cells and the risk of thyroid cancer returning. This is because when the level of thyroid hormone is high, your pituitary gland makes lessthyroid stimulating hormone (TSH). TSH promotes the growth of the thyroid gland and probably of thyroid cancer cells.
Targeted Therapy
This uses drugs to kill certain cancer cells. While chemotherapy kills all fast-growing cells, including cancer cells, targeted therapies go after specific genes and proteins inside cancer cells. These targeted drugs are called kinase inhibitors. Kinases are proteins that signal to cancer cells to grow. A kinase inhibitor would block these signals.
Targeted therapies are used when other treatments have not stopped your thyroid cancer.
If your thyroid cancer isn't treated, it could spread to your airways, esophagus (food pipe), and other structures. It could also spread to more distant body body parts, like your lungs, bones, and other soft tissues, and possibly be fatal.
If you have a lobectomy or total thyroidectomy, you may get temporary or permanent hoarseness or loss of voice because of nerve damage or irritation from the breathing tube used in surgery. In severe cases, you might have breathing problems too.
You might get low calcium levels from an accidental removal of the parathyroid glands during surgery. These glands are behind the thyroid, and they help to regulate calcium levels. Removal of these glands may also cause muscle spasms and tingling.
Complications from thyroid surgery are unusual if you have an experienced surgeon doing the procedure.
The outlook is generally very good. The five-year relative survival rate for thyroid cancer is 95% for all races and ages. This means that, on average, you're 95% as likely to be alive in five years as someone who didn't have thyroid cancer.
Of course, the survival rate changes depending on the stage and type of your cancer.
For papillary and follicular thyroid cancer, the five-year survival rates are 99.5% and 98%, respectively.
For medullary thyroid cancer, the five-year rate is 91%. For anaplastic cancer, the five-year rate is 8%.
Statistics are from the National Cancer Institute. They only apply to the stage of cancer when it was first diagnosed. They don't apply if the cancer comes back after treatment or spreads.
Most of the time, thyroid cancer can't be prevented. Most people get it for no known reason. But there are a few things you can do to reduce your risk.
Limit radiation exposure. Radiation exposure is a known risk factor for thyroid cancer, especially for children. If you or your child must have an imaging test (like an X-ray or CT scan), make sure your doctor or dentist uses shields to protect the head, neck, and body from radiation.
Keep a healthy body weight. Being overweight raises your risk of thyroid cancer.
Check if you're at high risk of thyroid cancer. This normally means you have family members who have had thyroid cancer. Talk to your doctor about having genetic testing to see if you carry the gene multiple endocrine neoplasia type 2 (MEN2), which puts you at high risk of MTC. Your doctor can also advise you on next steps if it turns out you do have the gene. Some people with this gene have opted for removal of their thyroids as a preventive measure.
Ozempic is a brand name of the drug semaglutide. Originally used to treat type 2 diabetes, it has become very popular for weight loss. Other brand names for semaglutide are Wegovy and Rybelsus. These drugs work for weight loss by tricking the brain so that you feel full faster and for a longer period of time.
The FDA has issued a boxed warning for Ozempic, Rybelsus, and Wegovy stating that studies in rodents have shown semaglutide caused thyroid C-cell tumors, and therefore people with a personal or family history of MTC should avoid taking it.
But studies published in 2024 showed there was little to no increased risk of contracting thyroid cancer while on these drugs. One study reported that the incidence of thyroid cancer in semaglutide-treated patients was less than 1%.
As of now, the FDA warning stands. So if you do have a family or personal history of MTC, be sure to tell your doctor before taking one of these drugs, whether for diabetes or weight loss.
Thyroid cancer starts when abnormal cancer cells change, or mutate, in your thyroid, a gland in your throat that controls your metabolism. The abnormal cells begin multiplying and, once there are enough of them, they form a tumor in your thyroid. You may see a swelling in your neck or throat. This type of cancer is very treatable. Treatment usually involves surgery to remove all or part of your thyroid followed by radiation therapy. The five-year survival rate is around 95%.
Is thyroid cancer serious?
It is serious but very curable.
Is thyroid cancer 100% curable?
It depends on the stage and type you have, but the most common types have cure rates of 98%-99.5%.
What is the first stage of thyroid cancer?
Stage I cancer (if you're under 55) means your tumor is any size and hasn't spread to nearby lymph nodes or other body parts. If you're over 55, it means that your tumor is completely inside your thyroid but no more than 4 centimeters (1.6 inches) across and it hasn't spread to nearby lymph nodes or other body parts.
Can thyroid cancer come back after a total thyroidectomy?
It come back even 20 years after treatment, as it's slow-growing. So it's important to keep following up with your doctor.
Can smoking cause thyroid cancer?
One review of 24 studies found that current smokers have a lower risk of getting thyroid cancer, implying that smoking has some sort of protective effect. But it's well-known that smoking can cause other kinds of cancer, particularly lung cancer. So don't take this as advice to start smoking.
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