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Stage 2 Non-Small Cell Lung Cancer

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Updated July 14, 2014

Stage 2 non-small cell lung cancer is defined as a “localized cancer,” that is, a tumor that is present in the lung and may have spread to local lymph nodes, but has not spread further. Tumors that have spread beyond these areas are referred to as "advanced cancers." About 30% of lung cancers are diagnosed when they are at stage 1 or 2, and the prognosis (long-term outcome) is significantly better than with later stages of the disease.

Definition of Stage 2 Non-Small Lung Cancer

Determining the stage of a lung cancer is very important in choosing the most appropriate treatment. Stage 2 describes cancers that have spread to nearby lymph nodes, or have not spread to lymph nodes but are large (greater than 3 cm (about 1 ½ inches) in size), in a region of the main bronchus, or are in a location where they have invaded the pleura (the lining of the lungs.) Stage 2 is divided again into stage 2A – tumors that are less than 3 cm is size but have spread to local lymph nodes, or 2B – tumors larger than 3 cm with spread to lymph nodes, or present in locations near the main bronchus or the lung lining.

Oncologists talk about stages of lung cancer based on something called the TNM system. In this system, T refers to the size of the tumor, N refers to the involvement of any lymph nodes and where they are located, and M indicates if there are any metastases, that is spread of the tumor to other regions of the body. Using the TNM system, stage 2 lung cancer is described as:

  • 2A – T1N1M0 – Meaning the tumor is less than 3 cm (1 ½ inches) in size, and it has spread to nearby lymph nodes.

  • 2B – T2N1M0 – The tumor is greater than 3 cm is size and has spread to local lymph nodes, or T3N0M0 – The tumor is any size and has not spread to lymph nodes, but is located in the airway or has spread to local areas such as the chest wall or diaphragm.

Symptoms

The most common symptoms of stage 2 lung cancer are a persistent cough, coughing up blood (hemoptysis), shortness of breath, pain in the chest or back, or repeated infections such as pneumonia or bronchitis. Since stage 2 lung cancer has not metastasized (spread) beyond the lungs, symptoms such as unintentional weight loss and fatigue are less common than in more advanced stages.

Treatment

Surgery is the treatment of choice for stage 2 lung cancer. There are 3 main types of lung cancer surgery that are done for lung cancer, and choosing which procedure is best depends upon the location of your tumor and general state of health. Most oncologists recommend adjuvant chemotherapy (chemotherapy after surgery) for those who undergo surgery for stage 2 lung cancer.

Radiation therapy is an option for those who are unable to have surgery due to the location of the tumor or general health concerns (inoperable lung cancer), and can sometimes result in a cure.

Many clinical trials are in progress to evaluate less invasive surgical methods, and new medications and radiation procedures that show promise for the future.

Risk of Recurrence

The overall recurrence rate (either locally or in other regions of the body) for localized lung cancer (stage 1 and stage 2) is between 20 and 50%. If a cancer recurs, further options for treatment may include radiation with or without chemotherapy, or one of the new targeted therapies that are being evaluated in many clinical trials.

Survival Rate

The overall 5-year survival rate for stage 2 lung cancer is 40-50%. These are only statistics and this number can vary depending upon your particular tumor and your general health.

What Can I Do to Help Myself?

Studies suggest that learning about your disease can improve your outcome. Ask questions. Learn about clinical trials that might be appropriate for you. Consider joining a support group. Learn to let your loved ones help, and enjoy their support in your journey.

Sources:

Edge, S. et al (Eds.). AJCC Cancer Staging Manual. 7th Edition. Springer. New York, NY. 2010.

Hotta, K. et al. Role of adjuvant chemotherapy in patients with resected non-small-cell lung cancer: reappraisal with a meta-analysis of randomized controlled trials. Journal of Clinical Oncology. 2004. 22(19):3850-7.

Kelsey, C. et al. Local/regional recurrence following surgery for early-stage lung cancer: A 10-year experience with 975 patients. Journal of Clinical Oncology. 2008. 26, No 15S(May 20 Suppl):7542.

Kelsey, C. et al. Local recurrence following initial resection of NSCLC: salvage is possible with radiation therapy. Cancer. 2006. 12(4):283-8.

Labadede, O. et al. TNM Staging of Lung Cancer – A Quick Reference Chart. Chest. 1999. 115(1):233-235.

National Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ). Stage II Non-Small Cell Lung Cancer. 08/15/12. http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/HealthProfessional/page9.

Scott, W. et al. Treatment of Non-small Cell Lung Cancer Stage I and Stage II: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition). Chest. 2007. 132(3 Suppl):234S-242S.

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