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Stage 1 Lung Cancer: What To Expect

Posted on August 06, 2021
Medically reviewed by
Mark Levin, M.D.
Article written by
Maureen McNulty

Stage 1 lung cancer is a lung tumor that has been caught early, before it has spread too far. People with early stage lung cancer often don’t have any symptoms. Treatments for stage 1 lung cancer are often limited, yet effective. Treatments often lead to good outcomes.

What Is Stage 1 Lung Cancer?

Doctors assign a stage to each case of lung cancer. The stage describes how far the cancer has spread in the body. Earlier-stage cancers, including stage 1 lung cancer, are smaller and located in one area. Advanced lung cancers have spread to tissues or organs in other parts of the body.

Lung cancer staging is different for each of the two main types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). In both cases, doctors use staging information to predict outcomes and recommend treatments.

Non-Small Cell Lung Cancer

Stage 1 NSCLC is a small tumor that has not spread very far, or has not spread at all. There is only one lung cancer stage that is less advanced. Stage 0 lung cancer is diagnosed when doctors only find abnormal cells in the surface layer of the airways.

Stage 1 NSCLC is divided into several substages. Stage 1A is a small tumor that only affects lung tissue. There are no cancer cells inside nearby lymph nodes (glands that help filter out cancer cells), and there are no metastases (cancer cells that have moved into distant tissues). Stage 1A is split into three parts based on how big the tumor is:

  • Stage 1A1 — The tumor is 1 centimeter or smaller.
  • Stage 1A2 — The tumor is between 1 centimeter and 2 centimeters across.
  • Stage 1A3 — The tumor is between 2 centimeters and 3 centimeters across.

Stage 1B lung cancer consists of tumors that are between 3 centimeters and 4 centimeters in size. This stage also includes any tumor that is 4 centimeters or less that fits one or more of these criteria:

  • The tumor is partially growing in the bronchus (an airway that connects the windpipe to the lung), but it has not reached the carina (the point where the windpipe splits into each main bronchus).
  • Cancer cells are growing in the pleura (the tissue that wraps around the lungs).
  • The airways are partially blocked.

Doctors also sometimes stage lung cancers as being localized (stages 1 and 2), regional (stage 3), or distant (stage 4).

Small Cell Lung Cancer

Doctors rarely use numbered stages to classify SCLC. Instead, they split SCLC into two groups: limited stage and extensive stage. Limited-stage SCLC is a tumor located in one part of the chest. In extensive-stage SCLC, cancer spreads to the opposite lung or to other organs, like the brain or bones. Most people with SCLC have extensive-stage disease by the time they receive their cancer diagnosis. Fewer than 5 percent of people have stage 0, 1, or 2 SCLC.

Symptoms of Stage 1 Lung Cancer

People with stage 1 lung cancer often do not have symptoms. Symptoms tend to develop once the cancer starts spreading. If symptoms exist, they may include:

  • Frequent coughing
  • Coughing up blood
  • Wheezing
  • Chest pain
  • Shortness of breath
  • Tiredness
  • Unexpected weight loss

If you experience any of these symptoms, it does not necessarily mean you have lung cancer. Several other conditions also cause these symptoms. However, if you are experiencing any health changes that could possibly be lung cancer symptoms, talk to your doctor.

Treatments for Stage 1 Lung Cancer

The lung cancer treatment options that doctors recommend are partly based on stage. Other factors, including the type of lung cancer, the location of the tumor, and the person’s general health, are also considered.

Treating Stage 1 Non-Small Cell Lung Cancer

People with early stage NSCLC who are in good overall health often need surgery to remove the tumor. Doctors will also remove part of the lung tissue, depending on how much of the lung is affected. There are a few possible surgical options:

  • Segmentectomy — Removal of a small part of the lung
  • Lobectomy — Removal of one of the lobes (a large section of the lung)
  • Pneumonectomy — Removal of the entire lung
  • Sleeve resection — Removal of part of the bronchus

After surgery, or if surgery isn’t an option, people with NSCLC will usually undergo other treatments. These may include radiation therapy or chemotherapy. During radiation therapy, a machine uses high-energy beams or particles to destroy cancer cells. People with early stage NSCLC sometimes use a treatment called intensity-modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT). In this treatment, doctors use CT scans to calculate and target focused radiation. IMRT or SBRT treatments don’t damage nearby healthy tissue as much as traditional radiotherapy.

If surgery was successful and the entire lung tumor was removed, chemotherapy may not be necessary, especially for people with stage 1A disease. Doctors may sometimes recommend chemotherapy for people with stage 1B NSCLC. If a tumor is more likely to return, chemotherapy may prevent it from coming back.

Treating Stage 1 Small Cell Lung Cancer

People with SCLC generally receive chemotherapy. They may also have radiation treatments at the same time, or after chemotherapy is done. Radiation treatments sometimes include radiation for the head, because SCLC often spreads to the brain. Surgery is usually not an option for people with SCLC.

Stage 1 Lung Cancer Outlook

People with earlier stages of lung cancer often have a good prognosis (outlook). People with localized NSCLC — cancer that hasn’t spread outside of one small area — have a five-year relative survival rate of 63 percent. This means that people with this disease are 63 percent as likely to live for five years or more, compared with people who don’t have lung cancer.

Stage is important when determining NSCLC outlook, but it’s not the only factor. The type of lung cancer also plays a role: People with squamous cell carcinoma often have a better prognosis than people with other types of NSCLC, because this type of lung cancer grows more slowly. When a tumor spreads to nearby tissues, such as the pleura, prognosis can be worse.

SCLC often leads to a poor outlook. About 27 percent of people with early stage SCLC live for five years or more after being diagnosed. People with SCLC may have a worse outlook if they have lost a lot of weight, regularly use tobacco, or have other health conditions such as heart disease.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 3,000 members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

Are you living with stage 1 lung cancer? Share your experience in the comments below, or start a conversation by posting on your Activities page.

A MyLungCancerTeam Member said:

I'm supposed to be stage 1, but the size doesn't match up with what they said. Also I have symptoms now. Haven't started treatments and no surgery yet.

posted 9 days ago

hug

Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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