Stage 3A lung cancer is considered regional, having spread beyond the lung. Treatment options include surgery, advanced drug therapies, chemotherapy, and radiation.

In 2021, 209,500 people in the United States received a lung cancer diagnosis, according to the Centers for Disease Control and Prevention (CDC). And approximately 87% of lung cancer diagnoses are non-small cell lung cancer (NSCLC).

NSCLC is categorized by stages. The higher the number, the more advanced the cancer. Doctors use a system known as “TNM” to stage tumors:

  • T stands for the primary tumor and looks at whether it has grown into nearby structures.
  • N stands for regional lymph nodes and looks at whether cancer has spread to a nearby lymph node.
  • M stands for metastasis and looks at whether cancer has spread to other organs, such as the other lung, brain, bones, adrenal gland, or liver.

Those living with stage 3A NSCLC have more options for treatment now than ever before and, with treatment, may experience remission.

Keep reading to learn more about NSCLC, including treatment options, remission, and survival rates.

The goal of treatment is to reduce the amount of cancer in your body. Medical interventions include removing or shrinking the tumors or strengthening the body’s immune system to target cancer cells.

These interventions can improve your outlook.

Doctors often recommend a combination of treatments for stage 3A lung cancer. These include:

  • surgery: to remove cancerous tumors
  • radiation therapy: to kill or shrink cancers before or after surgery
  • chemotherapy: to shrink tumors before surgery or to remove undetectable cancer possibly left behind after surgery
  • immunotherapy: to improve the immune system’s ability to fight off the cancer
  • targeted drug therapy: using medications like osimertinib (Tagrisso) on cancer cells that have the EGFR gene or other therapies like bevacizumab (Avastin) to limit the growth factors released by tumors

Often, doctors start with chemotherapy and radiation. Then, they can surgically remove the tumors that remain. Some people may receive surgery as a first option. This depends on the size and location of the cancer, as well as overall health.

Stage 3A lung cancer can go into what is called “remission,” which means it has been controlled beyond the point of detection or that its progression has been managed.

  • Complete: Doctors can no longer detect tumors measured before treatment.
  • Partial: The tumor is at least 50% smaller after treatment and remains that small for at least 1 month.

Remission is typically the goal of cancer treatment. Doctors can’t always say for sure that the cancer is completely gone. Some cancer cells may remain after treatment, just below the level of detection.

Sometimes, after the cancer has been undetected for some time, it comes back. This is called recurrence. If it has been less than a year since doctors were able to find cancer in the body, it may be called progression.

Cancer progression can mean that doctors thought they got all the cancer cells but missed some. It can also mean that some cancer cells resisted treatment and grew back.

There are three types of recurrence, depending on the location of the new cancer compared to the last cancer treated.

  • Local recurrence: lung cancer that reappears in the same place in the lungs
  • Regional recurrence: lung cancer that appears in the lymph nodes near the original cancer site
  • Distant recurrence: lung cancer that appears in a distant part of the body, like the brain

A recurrence means doctors have found lung cancer cells in the new site, even if that site is not the lungs. If the new cancer is not made up of lung cancer cells, then doctors call it a second cancer and not a recurrence.

The primary site of the second cancer, in part, determines treatment options and outlook.

In stage 3B NSCLC, the cancer has spread to the lymph nodes on the same side as the primary cancer site and possibly the opposite side. The cancer has also spread to adjacent areas, such as the:

  • chest wall
  • heart
  • breastbone
  • esophagus
  • trachea
  • backbone

At stage 3B, doctors treat the cancer with a combination of:

  • chemotherapy
  • radiation
  • laser therapy
  • immunotherapy

Doctors may also recommend palliative treatment in addition to other treatments to increase comfort and quality of life.

While surgery is a treatment option for stage 3A NSCLC, it cannot remove all the cancer in stage 3B.

People with stage 3 NSCLC may also be interested in:

  • clinical trials for targeted therapy
  • treatments involving a radiosensitizer
  • new radiation schedules

Doctors determine relative survival rates by comparing the life expectancy of people with a certain cancer diagnosis and stage with those who don’t have that cancer.

The percentage is the relative likelihood of living past a certain amount of time, normally 5 years, compared with those not living with that cancer diagnosis.

The American Cancer Society uses the National Cancer Institute’s SEER database to assess relative survival rates. The SEER database divides cancer stage at the time of diagnosis by the extent of spread:

  • Localized: There is no cancer outside the lung.
  • Regional: Cancer has spread outside the lung to nearby areas or lymph nodes.
  • Distant: Cancer has spread to distant parts of the body.

Stage 3A NSCLC means the cancer has spread to the lymph nodes and may be present in nearby tissue and organs. Since the cancer has moved outside the lungs, the cancer is considered regional. The 5-year relative survival rate for regional NSCLC is 37%.

This statistic is based on people who received a diagnosis between 2012 and 2018. For this reason, survival rates are not predictive. Treatments are changing constantly, and outcomes could be different for people currently undergoing treatment.

Moreover, according to the American Cancer Society, there has been a long-term decline in deaths from lung cancer.

The outlook for stage 3A NSCLC can be very different from person to person. Tumor size, the extent of spread to lymph nodes, and other spread vary within stage 3A.

For example, stage 3A NSCLC for people with two positive nodes has a 5-year survival rate of 10% to 15%. Cases where the spread is more extensive may have a lower overall survival rate.

It’s best to work with your doctor to discuss the best types of treatment for you and how they might influence your outlook.

Stage 3A lung cancer is treated with surgery, chemotherapy, radiation, new drugs to target cancer genes or behaviors, and immunotherapy.

The outlook for people with stage 3A lung cancer is affected by the subtype of cancer, your age, health, genetics, and response to treatment.

Living with stage 3A lung cancer is a journey unique to each individual. Your medical team can help you find the best course of therapy and support.