What Is Stage I Lung Cancer Life Expectancy?

Understanding Factors Which Affect Survival Rates

female doctor talking to patient
What is the life expectancy of stage I lung cancer?. istockphoto.com

One of the first questions a person may ask when diagnosed with stage I lung cancer is, "What is the life expectancy." Sadly, lung cancer has a reputation of having a poor prognosis. That said, stage 1 is the earliest stage of invasive lung cancer and many people survive long term with the disease. Let's look at some of the variables that might affect your prognosis as well as the advances taking place which are improving survival.

Stage I Lung Cancer: Definition

Stage I lung cancer is the earliest stage of invasive non-small cell lung cancer. (Stage 0 lung cancer is the pre-invasive stage of lung cancer or carcinoma in situ).

Tumors that are classified as stage I are broken down into two classes:

  • Stage IA lung cancers are only in the lung and are 3 cm (roughly an inch and a half) in diameter or less.
  • Stage IB lung cancers are between 3 and 5 cm in diameter and may have a) spread to the main bronchus, b) spread to the inner membrane overlying the lung, or c) part of the lung may be inflamed or collapsed.

Stage I Lung Cancer Life Expectancy

Since lung cancer has a reputation of being aggressive and having a poor prognosis, the question of survival often comes up. Before going any further it's important to note that the treatments for lung cancer are improving and the survival rate is improving. In addition, everyone is different.

And finally, statistics tell us how someone did in the past with lung cancer. Since there are so many new treatments these are not necessarily an accurate estimate.

Variables That Affect Lung Cancer Survival Rates

Some of the variables that may affect lung cancer survival include:

  • Your particular lung cancer type and location: Roughly 85 percent of lung cancers are considered non-small cell lung cancer These cancers tend to spread more slowly than small cell lung cancer, though small cell lung cancer tends to respond quite well to chemotherapy and radiation therapy, at least initially.
  • The location of your cancer: Even though surgery is often the treatment of choice for stage 1 lung cancer, some of these tumors are located in areas which make surgery dangerous. If surgery is not possible, there are two types of radiation therapy which may be used with a curative intent: stereotactic body radiotherapy (SBRT) and proton therapy. (Survival is somewhat better with a VATS lobectomy vs SBRT).
  • The molecular profile of your tumor: We currently have treatments for people with some genetic changes in their tumors. Molecular profiling (gene testing) should be done for everyone with non-small cell lung cancer. Drugs are available for people with EGFR mutations, ALK rearrangements, and ROS1 rearrangements, and clinical trials are evaluating the treatment of lung cancers with other genetic profiles as well. (These treatments are not usually used for stage 1 disease, but are available if the cancer should recur or spread).
  • Your age: Younger people tend to live longer than older people with lung cancer.
  • Your sex: The life expectancy for a woman with lung cancer is higher at each stage of the disease.
  • Your general health at the time of diagnosis: Being healthy overall at the time of diagnosis is associated with a longer life expectancy, and a greater ability to withstand treatments that may extend survival.
  • How you respond to treatment: Side effects of treatment vary among different people, and may limit your ability to tolerate treatment.
  • Other health conditions you may have: Health conditions such as emphysema or heart disease may lower stage I lung cancer life expectancy. Those who do not have COPD have a better prognosis than those who have the disease.
  • Smoking: Quitting smoking before surgery for stage I lung cancer, appears to significantly improve the survival rate.  At the current time, the majority of people who develop lung cancer do not smoke, but for those who do there are many reasons people with cancer should quit smoking, including survival.
  • Where you are treated: A few studies have found that people who have surgery for lung cancer at an institution that does more of these surgeries (such as a teaching hospital or large cancer center) have better outcomes.

In addition to all the differences note above among people, every cancer is different as well. From a molecular standpoint, if there were 100 people with stage I lung cancer in a room, they would have 100 different cancers on a molecular level. Different molecular characteristics can result in different behavior of tumors.

Stage I Lung Cancer Life Expectancy Statistics

In addition to variations between different people and different cancers, it is important to keep in mind that statistics are frequently a few years old. Many of the treatments now available for lung cancer were not around when those numbers were derived. For example, there are several immunotherapy and targeted drugs which have been approved since the beginning of 2015.

Currently, the overall 5-year survival rate is 49 percent for people with stage IA lung cancer and 45 percent for people with stage IB non-small cell lung cancer. These rates may be higher for people who have lung cancer detected by screening alone, and can be as high as 90 percent.

Stage I Lung Cancer and Risk of Recurrence

After treatment for stage I lung cancer, the possibility of lung cancer recurrence does exist. It's thought that between 30 and 50 percent of stage I lung cancers may recur, and adjuvant treatments such as chemotherapy are sometimes used to reduce this risk. Recurrence may occur in one of three ways:

  • Local recurrence refers to cancers which come back in the lung, near the original tumor.
  • Regional recurrence refers to cancers which recur in the lymph nodes near the original tumor.
  • Distant recurrence refers to cancers which recur at distant sites in the body, most commonly the bones, brain, liver, or adrenal glands. When a cancer recurs at a distant site it is referred to as metastatic or stage 4 cancer.

Unfortunately, most recurrences of stage I lung cancer are at distant sites. Yet even with a recurrence, survival is improving. In fact, most of the recent advances in lung cancer treatment are for stage 4 disease.

The Importance of Clinical Trials

According to the National Cancer Institute, everyone with any stage of lung cancer should consider the option of becoming involved in a clinical trial. For stage 1 disease there are now several trials in place looking at reasons an early cancer may recur as well as adjuvant treatments which may reduce this risk.

A Word From Verywell on Lung Cancer Prognosis

The prognosis for stage 1 lung cancer is higher for other stages of the disease, yet at least a third of these tumors will recur. Treatments are improving but there are also things you can do yourself to improve your survival rate. Ask a lot of questions. Get a second opinion, ideally from a cancer center which performs large volumes of these surgeries. Tap into a lung cancer support group or online support community. Being your own advocate in your cancer care not only reduces anxiety, but may improve your outcome as well.

Sources:

American Cancer Society. Cancer Facts and Figures 2017. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2017.html

National Cancer Institute. Non-Small Cell Lung Cancer Treatment (PDQ) - Health Professional Version. 03/31/17. https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq#section/all.

Wang, X., Janowczyk, A., Zhou, Y. et al. Prediction of Recurrence in Early Stage Non-Small Cell Lung Cancer Using Computer Extracted Nuclear Features From Digital H and E Images. Scientific Reports. 2017. 7(1):13543.

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