Stage 2 lung cancer

Stage 2 lung cancer is still considered early lung cancer, but it's usually locally advanced.

What are stage 2A and stage 2B lung cancers?

NSCLC stage 2 lung cancer is further classified as one of two subtypes, based on whether it’s spread to nearby lymph nodes or other parts of the lung or chest.

In stage 2A lung cancer, the tumor measures between 4 cm and 5 cm and the lymph nodes are clear. However, cancer may be found in the main airway, or bronchus, of the lung and/or into the layer of the membrane covering the lung. Also, all or part of the lung may have collapsed or become inflamed.

Stage 2B lung cancer has one of these characteristics:

• The tumor measures up to 5 cm, and cancer cells are found in the lymph nodes near the affected lung. Additionally, the cancer has spread to the main airway and/or into the layer of the membrane that covers the lung, or all or part of the lung is collapsed or inflamed.
• The tumor measures between 5 cm and 7 cm, and no cancer has been found in the lymph nodes. In many cases the cancer has spread to the membrane that lines the inside of the chest wall, or the chest wall itself, or the phrenic nerve close to the lung, or the outer tissue layer of the sac surrounding the heart.
• More than one tumor has been found in the same lobe section of the lung.

Stage 2 lung cancer symptoms

Most early lung cancers don't cause symptoms. However, it’s still possible for stage 2 lung cancer to cause:

• A new cough that doesn’t go away
• A chronic cough that’s getting worse
• Coughing up bloody mucus
• Shortness of breath
• Ongoing chest pain
• Frequent lung infections

Stage 2 lung cancer treatment

Various types of treatments are used to treat stage 2 lung cancer, including those below.

Surgery

Surgery is typically the first-line treatment for stage 2 lung cancer for otherwise healthy patients. Surgical options for stage 2 lung cancer include:

Segmentectomy: This procedure is used to remove a portion of the lung that includes the tumor, as well as some surrounding tissue.

Sleeve resection: Also known as a sleeve lobectomy, this surgery is used to remove the lobe with cancer and a part of the main bronchus connected to that lung. The remaining end of the bronchus is then connected to an unaffected lobe.

Lobectomy: During this procedure, the surgeon removes the lobe of the cancerous lung.

Pneumonectomy: This procedure is used to remove the entire lung. The surgeon also removes any lymph nodes that are likely to have cancer in them.

A second surgery may be required if cancer cells have been found at the edges of the tumor.

Radiation therapy

Treatment with high energy X-rays or other forms of radiation may help target any remaining cancer cells. Radiation therapy may be delivered externally or internally.

Chemotherapy and other drug therapies

Surgery may be followed by chemotherapy and immunotherapy for up to a year. Immunotherapy drugs are designed to shut down key proteins on immune cells, because cancer spreads easily when these proteins are turned on. Radiation therapy may also be used, either alone or in combination with chemotherapy, to treat stage 2 lung cancer.

If the lung tumor is larger than 4 cm, immunotherapy with nivolumab plus chemotherapy before surgery may be an option.

If the cancer cells show mutations in the epidermal growth factor receptor (EGFR) gene, EGFR inhibitors may be recommended as part of treatment. This targeted therapy drug targets specific genes and their proteins involved in the growth and spread of cancer cells.

Stage 2 lung cancer survival rate

According to the National Cancer Institute, the five-year survival rate for treated stage 2 non-small cell lung cancer is 35 percent. This means about 35 out of 100 patients are expected to be alive five years after treatment.