Treatment Options by Stages

Stage II

In stage II the cancer cells have spread to nearby lymph nodes.

General Treatment Options. Surgery, usually removal of a lobe (lobectomy) or one lung (pneumonectomy) is the treatment of choice. Five-year survival rates associated with stage II surgery can vary. A 2000 review of existing research places the numbers as high as 40 - 50%, but notes that they can drop to 25% and below if the cancer has spread beyond the immediate lymph nodes.

Patients whose cancer is inoperable may consider radiation treatments. In patients who can complete treatment, five-year survival rates average 20 - 30%, with higher rates for stage IIA. Patients should consider clinical trials for prevention of recurring cancer after primary treatment. To date, however, supplementing surgical treatment with radiation or chemotherapy does not appear to prolong survival rates.

• Stage IIA (T1, N1, M0). Survival rates can be as high as 60%. Treatment options are:
  • Surgery
  • Radiation
  • Clinical trials of chemotherapy following surgery
  • Clinical trials of chemotherapy before, after, or during radiation treatments
  • Clinical trials of chemotherapy to reduce tumor size before surgery (induction therapy)
• Stage IIB (T2, N1, M0) or (T3, N0, M0). Survival rates can be over 40%. Treatment options are:
  • Surgery
  • Radiation
  • Clinical trials of chemotherapy following surgery
  • Clinical trials of chemotherapy before surgery (induction therapy)
  • Clinical trials of chemotherapy before, after, or given at the same time as radiation treatments

Stage III

In stage III, the cancer cells have spread beyond the lung to the chest wall, diaphragm, or further lymph nodes, such as those in the neck.

General Treatment Options. Generally, the treatment of choice for stage III tumors is radiation and sometimes surgery, chemotherapy, or combinations of all three.

Combination approaches may be significantly more effective than single treatments. For example, of particular interest is a treatment approach that starts with chemotherapy and radiation, given at the same time, followed by surgery. In one study, 5-year survival in stage III patients treated this way was nearly 50%.