How long can I live after getting lung cancer: staging is key!

As a thoracic surgeon, I am often asked by lung cancer patients and their families, “Is this disease early or late? How long can I live?” Because everyone has differences, it is difficult for doctors to infer the specific time. Doctors can tell you the survival rate of the disease, such as the 1-year, 2-year, 5-year, and 10-year survival rates, with the most commonly used being the 5-year survival rate. The survival rate is closely related to the staging of lung cancer. The staging of lung cancer is commonly referred to as the early, middle, and late stages by the general public. Clinically, it is usually divided into four stages, each of which is further subdivided, totaling 11 stages. Each stage is different, even vastly different.

Based on the 8th edition TNM staging developed by the International Association for the Study of Lung Cancer (IASLC), statistics were conducted on 70967 non-small cell lung cancer patients from 1999 to 2010.

Stage 0: also known as carcinoma in situ, it has been classified as a prodromal lesion with a five-year survival rate of nearly 100%. By surgically removing the tumor, cancer cells can be “uprooted” and clinical cure can be achieved.
Stage I: Belongs to early lung cancer, with small tumor size, no lymph node metastasis or distant metastasis, but subdivided according to tumor size and invasion:
Stage I A1: Tumors with a diameter of ≤ 1cm have a five-year survival rate of around 90%. Small tumors are easily removed by surgery, and patients have a high hope of recovery.
Stage IIA2: Tumor diameter>1cm and ≤ 2cm, with a five-year survival rate of around 85%. Although the tumor is slightly larger, early detection and treatment can lead to long-term survival for most patients.
Stage A3: Tumors with a diameter greater than 2cm and less than 3cm have a five-year survival rate of approximately 80%. Compared to the previous two stages, the survival rate has decreased, but there is still a great possibility of cure.
Stage IB: Tumors with a diameter greater than 3cm but less than or equal to 4cm; or tumors with a diameter less than or equal to 4cm but invading the visceral pleura and main bronchus, causing atelectasis and leading to obstructive pneumonia. The tumor is “restless” and the five-year survival rate is around 73%, with an increased risk of recurrence. Individuals with high-risk factors require chemotherapy or targeted therapy.
Stage II: Enters the stage of local progression, with larger tumors or lymph node metastasis.
Stage IIA: The five-year survival rate is about 65%. Timely and standardized treatment can help some patients control their condition and prolong their survival.
Stage IIB: The condition has advanced further than Stage IIA, with a five-year survival rate of approximately 56%.
Stage III: The tumor has a wider range of invasion and lymph node metastasis, requiring a combination of surgery, radiotherapy, chemotherapy, targeted therapy, and other methods.
Stage IIIA: The five-year survival rate is approximately 41%.
Stage IIIB: The five-year survival rate is approximately 24%.
Stage IIIC: The five-year survival rate is approximately 12%.
Stage IV: It belongs to the late stage and requires conservative treatment such as radiotherapy, chemotherapy, targeted therapy, and immunotherapy, except for a few cases of oligometastasis and other surgeries. At that time, under the medical level, the 5-year survival rate of patients with pathological stage IV was not recorded.

However, with the development of medicine, new treatment methods and drugs continue to emerge, such as updates in surgical techniques, the popularity of targeted drugs, immunotherapy, and the widespread use of CT to detect lung cancer earlier and prolong survival. The above data has a certain degree of delay. In recent years, the treatment methods for lung cancer have been advancing rapidly, and the survival rate has also been increasing. Therefore, we hope that every patient will not give up hope and be brave enough to fight to the end!