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What Does Having Stage 3 Lung Cancer Mean?

Definition of Stage 3 Lung Cancer

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Updated August 14, 2014

Stage 3 lung cancer is best described by separating the stages into stage 3A and stage 3B.

Stage 3A lung cancer includes tumors that are large and have spread to nearby lymph nodes, or tumors of any size that have spread to lymph nodes that are further away but still on the same side of the body as the cancer.

Stage 3B lung cancer is defined as a tumor of any size that has spread to distant lymph nodes, has invaded other structures in the chest (such as the heart or esophagus. Tumors involving a malignant pleural effusion (fluid build-up containing cancer cells in the pleural cavity between the layers lining the lungs) were changed from stage 3B to stage 4 in 2009.

Oncologists use the TNM system to further define stages of lung cancer. A simplified description of the TNM system includes:

T refers to tumor size:

  • T1 – A tumor is less than 3 cm (1 ½ inches) in size.
  • T2 –The tumor is greater than 3 cm.
  • T3 – The tumor can be any size, but is near the airway or has spread to local areas such as the chest wall or diaphragm.
  • T4 – The tumor is any size, but is located in the airway or has invaded local structures such as the heart, or the esophagus.

N refers to lymph nodes:

  • N0 – No nodes are affected.
  • N1 – The tumor has spread to nearby nodes on the same side of the body.
  • N2 – The tumor has spread to nodes further away but on the same side of the body.
  • N3 – Cancer cells are present in lymph nodes on the other side of the chest from the tumor, or in nodes near the collarbone or neck muscles.

M represents metastatic disease:

  • M0 – No metastases are present.
  • M1 – The tumor has spread (metastasized) to other regions of the body or the other lung.

Using the TNM System, stage 3A lung cancer is described as:

  • T1N2M0 – The tumor is less than 3 cm in size and has spread to lymph nodes further away but on the same side of the body as the tumor.
     
  • T2N2M0 – The tumor is larger than 3 cm and has spread to lymph nodes further away but on the same side of the body.
     
  • T3N1M0 – The tumor is any size but is near an airway or has spread locally to an area like the chest wall or diaphragm, and nearby lymph nodes are affected.
     
  • T3N2M0 – The tumor is any size but is near an airway or has spread locally to an area like the chest wall or diaphragm, and lymph nodes that are further away but on the same side of the body are affected.

Using the TNM System, stage 3B is described as:

  • Any T, N3, M0 – A tumor of any size that has spread to lymph nodes on the other side of the chest from the tumor or to nodes near the collarbone or neck muscles, but has not spread to distant regions of the body.
     
  • T4, Any N, M0 – A tumor of any size that is located in the airways, or has invaded local structures such as the heart or esophagus. Nodes may or may not be involved, and when affected, can be near the tumor or further away in the chest or neck, but the tumor has not spread to distant regions of the body.

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