Lung cancer stage 3: treatment and prognosis

Stage 3 lung cancer is determined by the size of the tumor and damage to the lymph nodes. The following tumors belong to this stage:
more than 7 cm, without metastases in the lymph nodes.
less than 7 cm, with metastases in several lymph nodes.
Stage 3 lung cancer is further divided into three substages (3a, 3b, 3c), depending on how many distant lymph nodes are affected. Stage 3b is considered already advanced because there are lesions in the supraclavicular lymph nodes or on the opposite side of the chest

Typically, peripheral lung cancer has a hidden course - a malignant tumor that develops from bronchioles, far from the root of the lung. Growing in the lung tissue, such cancer does not cause pain for a long time, since it lacks pain receptors. Complaints appear when the malignant process spreads to the lymph nodes around the large bronchi, causing coughing, or to the pulmonary pleura, leading to chest pain and shortness of breath. When the tumor begins to disintegrate, streaks of blood appear in the sputum when coughing (hemoptysis).

Cough is the most common symptom of lung cancer and is often mistaken for an acute respiratory infection or chronic smoker's cough. Stage three cancer can manifest itself as regular pneumonia. The attending physician should be alert to frequent pneumonia that does not respond well to antibiotic treatment. Frequent coughs are especially suspicious in smokers and people over 45 years of age. This is why regular screening in this population is necessary.

To diagnose a malignant lesion, the most informative methods are radiation diagnostics: radiography, magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET). Conventional plain chest radiography in some cases may be uninformative, but low-dose radiography - fluorography - plays an excellent role in screening. Preventive FLG helps to notice lesions in the lungs in time and examine them more precisely.

If the tumor is located near large bronchi, fiberoptic bronchoscopy is applicable, during which a biopsy can also be performed - taking a sample of the tumor. A biopsy can also be done by puncture through the chest, under hardware control. If the lesion is located in the pleura, thoracoscopy is performed.

Life expectancy at stage 3 of lung cancer depends on many factors: the age of the patient, the size of the tumor, the presence of metastases in distant lymph nodes, the location of the tumor in relation to the pleura and the root of the lung, the histological type of the tumor, concomitant diseases.

At stage 3a, when surgical treatment is still possible, survival rates reach 33-36%. At stage 3b, no more than 13-26% survive, and at stage 3c - only 8%.

Stage 3 cancer of the right lung is no different from the left lung. The difference, according to some data, may only be in the incidence of tumor occurrence. If the right main bronchus can be considered a continuation of the trachea, then the left one departs from it at an angle. As a result, irritating particles, along with the inhaled air, can enter the right lung in greater quantities. In addition to tobacco smoke, dust in the air at the workplace can be a carcinogen: asbestos, cadmium, nickel, chromium, etc.

Surgical treatment remains the main treatment method for pulmonary malignancy. Depending on the extent of the tumor, a segment (segmentectomy), a lobe (lobectomy) or the entire lung (pulmonectomy) is removed. Regional lymph nodes must be removed. Chemotherapy is prescribed after surgery to destroy possible small malignant lesions that are not visible to the eye. Chemotherapy may be given before surgery to shrink the size of the primary tumor. If the cancer is inoperable (there are distant metastases), radiation therapy (in combination with chemotherapy) is prescribed to the tumor area.

As an additional arsenal of drugs, new classes of anticancer drugs have appeared in oncology in recent years. Immunotherapy and targeted therapy are usually prescribed when chemotherapy fails.

For stage 3 lung cancer, the prognosis depends not only on many patient factors (age, gender, concomitant diseases), tumor factors (size, location, histological type), but also on the results of the treatment. Even with a successful operation, a relapse is possible after some time, which will require new intervention. Therefore in oncology they never talk about a successful cure. The absence of ongoing tumor growth is called “remission.”

It is difficult to make a survival prognosis for patients with stage 3 lung cancer, since it must also take into account the disease’s response to treatment. The prescribed first-line drugs may turn out to be ineffective in this particular case, and then they move on to second-line drugs or even targeted therapy.

Even if regression of tumor growth has occurred, the patient remains under the follow-up of an oncologist, who monitors the results of regular examinations. The purpose of these examinations is to detect a possible relapse in time and resume treatment.