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How Fast Can Lung Cancer Progress? Time From Stage 1 to Stage 4

Medically reviewed by Leonora Valdez, M.D.
Written by Emily Wagner, M.S.
Posted on July 3, 2024

If you’ve recently been diagnosed with early-stage lung cancer, you may wonder how fast it can progress. Unfortunately, there’s no exact answer to this question because each lung cancer case is unique. Your progression may depend on the type of lung cancer you have, what genetic changes it has, and your treatment plan.

In this article, we’ll explore how fast lung cancer can progress from earlier to later stages. We’ll also cover the different factors that play a role in lung cancer progression. Your doctor or oncologist (cancer specialist) can help explain more details about your individual lung cancer case.

How Does Lung Cancer Develop and Progress?

Cancer develops when cells gain new mutations (changes) in their DNA. These changes typically accumulate slowly over many years. Eventually, the cells have enough mutations to begin growing and dividing quickly. Many cells don’t respond to normal signals that tell them to stop dividing. Other mutations help the cells hide from the immune system so they avoid destruction.

Uncontrolled cell growth eventually leads to a tumor. Tumors can go undetected for months or years, depending on the cancer type. People with lung cancer usually aren’t diagnosed until their cancer has grown and spread into nearby tissues or to other parts of the body.

Stages of Lung Cancer

To better understand how lung cancer progresses over time, it helps to understand cancer staging. Doctors use the TNM staging system to track how much lung cancer has grown and spread. The stages are numbered 1 through 4, with stage 1 being the least severe and stage 4 being the most severe or advanced. (Lung cancer stages are sometimes rendered in Roman numerals, e.g., “stage III” instead of “stage 3.”)

The TNM staging system stands for:

  • Tumor — The size and spread of the lung cancer tumor in the lung and in nearby tissues or structures
  • Lymph nodes — The extent of tumor spread into nearby lymph nodes (immune system tissues)
  • Metastasis — Whether the cancer has spread to distant organs of the body

Each letter has a number after it to indicate how advanced the cancer is. For example, a T1 tumor is smaller and has spread less than a T4 tumor. There may also be letters to further differentiate between stages. A T1a tumor is less advanced than a T1b tumor.

Lung Cancers Grow at Different Rates

Lung cancer growth rates are usually divided based on the specific cancer type. There are two main types of lung cancer — non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC accounts for around 80 percent to 85 percent of lung cancer cases, while SCLC accounts for 10 percent to 15 percent. Generally speaking, SCLC is much more aggressive than NSCLC. This means that it grows and spreads much faster than NSCLC.

When researchers talk about how quickly cancer cells grow, they talk about “doubling times” or “doubling rates.” These terms refer to the amount of time it takes for cancer cells to double in number. They can also measure the volume or size of the tumor to get an accurate doubling time.

Studies show that SCLC has a faster doubling time than NSCLC, making it more aggressive. Since each person’s lung cancer case is unique, there is a wide range of doubling times. Studies show that SCLC tumors double in size every 25 to 217 days.

Lung Cancer Growth Rates by NSCLC Subtype

NSCLC is divided into three main subtypes based on the cells it develops within:

  • Adenocarcinoma
  • Squamous cell carcinoma (SCC)
  • Large cell carcinoma

Studies have found that doubling times vary between the NSCLC subtypes.

One report looked at 371 lung cancers that were removed with surgery. The authors divided the cases by subtype and looked at the median volume doubling times. This refers to the amount of time it took for at least half of the lung cancer cases to double in volume.

The median volume doubling times by NSCLC subtype were:

  • Adenocarcinoma — 261 days
  • SCC — 70 days
  • Other lung cancers — 70 days

Overall, the study found that adenocarcinoma tumors tend to grow slower than SCC tumors. This may mean that SCC cases may progress faster between stages than adenocarcinoma cases.

Lung Cancer Progression: How Fast Does It Grow and Spread?

Most lung cancer cases are diagnosed in the later stages, which makes it difficult to measure how quickly they progress. This is because many people don’t experience symptoms until the cancer has grown and spread. People with NSCLC are frequently diagnosed at stage 3 or 4. At these stages, the cancer has typically spread to:

  • Nearby lymph nodes
  • Nearby lung tissues and other chest structures
  • Other parts of the body, known as metastasis

The majority of people with SCLC are also diagnosed with extensive stage disease (stage 4). This means their cancer has metastasized to other parts of the body.

Once Lung Cancer Begins, It Grows Quickly

We can’t predict exactly how fast lung cancer progresses from one stage to another. However, we do know that once lung cancer forms, it quickly continues growing and spreading. One study published in the journal Scientific Reports looked for ways to tell how fast NSCLC progresses from early to advanced stages.

The authors found that NSCLC tended to grow faster in Caucasian participants than in Asian and African-American participants. This may be due to differences in smoking habits or which lung cancer mutations are present. The KRAS mutation is primarily found in Caucasian populations, according to the study, and it’s associated with worse survival rates.

The authors also looked at the tumor size and spread (i.e., T from the TNM staging system). They noted that there was a small age difference between participants with early and advanced T stages. For example, the difference between those with T1a tumors and those with T4 tumors was 0.92 years. This means that once lung cancer forms and is found on imaging tests, it grows very quickly.

Treatments Help Slow Lung Cancer Growth

The overall goal of lung cancer treatment is to either remove the tumor entirely or slow cancer growth. Every year, doctors and researchers discover new and improved treatment options to improve survival. Depending on your lung cancer case, you may be treated with a combination of:

  • Surgery — Removes the tumor
  • Radiation therapy — Uses radiation beams to destroy cancer cells
  • Chemotherapy — Uses toxic chemicals to kill cancer cells
  • Targeted therapy — Targets proteins found in cancer cells to block their growth
  • Immunotherapy — Activates the immune system to fight and destroy cancer cells

Since lung cancer spreads quickly once it forms, it’s important to start treatment as soon as possible. There are also newer therapies available to slow tumor growth for metastatic lung cancer, which can help you live longer. By working closely with your cancer care team, you can improve your overall health and quality of life living with lung cancer.

Lifestyle Changes To Lower Lung Cancer Risk and Slow Growth

Along with lung cancer treatments, you can take other steps to potentially slow tumor growth.

Researchers have found that SCC tumor cells rely more on sugar to grow compared to other lung cancer types. This is because they have a receptor on the outside of the cell used to transport glucose — the body’s preferred form of sugar. By limiting how much sugar you eat, you may be able to slow cancer growth and improve your outlook.

You likely know that smoking is one of the main causes of lung cancer. Cigarette smoke contains cancer-causing compounds that damage the DNA inside cells. One study found that smoking two packs of cigarettes per day increases the risk of lung cancer relapse and metastasis by 58 percent. If you quit smoking before or at the time of your lung cancer diagnosis, your chances of survival greatly improve.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Do you have other questions about how fast lung cancer can progress from stage to stage? Share them in the comments below, or start a conversation by posting on your Activities page.

References
  1. How Fast Can Lung Cancer Spread — Moffitt Cancer Center
  2. What Is Cancer? — National Cancer Institute
  3. DNA Damage and Gene Mutations — FORCE
  4. Epidemiology of Stage III Lung Cancer: Frequency, Diagnostic Characteristics, and Survival — Translational Lung Cancer Research
  5. Non-Small Cell Lung Cancer Stages — American Cancer Society
  6. Lung Cancer Types — City of Hope
  7. Doubling Time — National Cancer Institute
  8. Small Cell Lung Cancer Doubling Time and Its Effect on Clinical Presentation: A Concise Review — Clinical Medicine Insights: Oncology
  9. The Impact of Histology and Ground-Glass Opacity Component on Volume Doubling Time in Primary Lung Cancer — Journal of Thoracic Disease
  10. Small Cell Lung Cancer Stages — American Cancer Society
  11. Time-to-Progression of NSCLC From Early to Advanced Stages: An Analysis of Data From SEER Registry and a Single Institute — Scientific Reports
  12. KRAS-Mutant Non-Small Cell Lung Cancer: An Emerging Promisingly Treatable Subgroup — Frontiers in Oncology
  13. Treatment of Lung Cancer — Centers for Disease Control and Prevention
  14. Immunotherapy for Non-Small Cell Lung Cancer — American Cancer Society
  15. Long-Term Survival of Patients With Metastatic Non-Small-Cell Lung Cancer Over Five Decades — Journal of Oncology
  16. A Breakthrough in the Connection Between Sugar and Lung Cancer — American Lung Association
  17. The Distinct Metabolic Phenotype of Lung Squamous Cell Carcinoma Defines Selective Vulnerability to Glycolytic Inhibition — Nature Communications
  18. Lung Cancer Risk Factors — Centers for Disease Control and Prevention
  19. Impact and Interactions Between Smoking and Traditional Prognostic Factors in Lung Cancer Progression — Lung Cancer
  20. Quitting Smoking at or Around Diagnosis Improves the Overall Survival of Lung Cancer Patients: A Systematic Review and Meta-Analysis — Journal of Thoracic Oncology
    Posted on July 3, 2024
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    Leonora Valdez, M.D. received her medical degree from the Autonomous University of Guadalajara before pursuing a fellowship in internal medicine and subsequently in medical oncology at the National Cancer Institute. Learn more about her here.
    Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.

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