Day 17 – LUNG CANCER: Prognosis and Reality [read more=”Click here to Read More” less=”Read Less”]
Keeping in mind all of those caveats about which we spoke yesterday, in Topic #16 (“Lung Cancer: Understanding Your Prognosis”), here are the 5-year survival rates for the two main types of lung cancer from the American Cancer Society:
Non-Small Cell Lung Cancer (NSCLC) (average of all subtypes), 85-90% of lung cancers
- The 5-year survival rate for people with stage IA1 NSCLC is about 92%. For people with stage IA2 NSCLC, the 5-year survival rate is about 83%. For people with stage IA3 NSCLC, the 5-year survival rate is about 77%.
- The 5-year survival rate for people with stage IB NSCLC is about 68%.
- For stage IIA cancer, the 5-year survival rate is about 60%. For stage IIB cancer, the survival rate is about 53%.
- The 5-year survival rate for stage IIIA NSCLC is about 36%. For stage IIIB cancers the survival rate is about 26%. For stage IIIC cancers the survival rate is about 13%.
- NSCLC that has spread to other parts of the body is often hard to treat. The 5-year survival rate for stage IVA NSCLC is about 10%, and for stage IVB the 5-year survival rate is less than 1%. Still, there are often many treatment options available for people with these stages of cancer.
One key point is also subtype. Generally Adenocarcinoma (around 40% of lung cancers) has the best prognosis and most treatment options, followed by squamous cell (25-30%). Large-cell (10-15%) is the most lethal type of NSCLC, and it often behaves and is treated like SCLC. There are also a range hybrids or undifferentiated types (around 5%) which can have a spectrum of characteristics and outcomes.
Small Cell Lung Cancer (SCLC), 10-15% of lung cancers:
- The 5-year relative survival rate for people with stage I SCLC is about 31%.
- For stage II SCLC, the 5-year relative survival rate is about 19%.
- The 5-year relative survival rate for stage III SCLC is about 8%.
- SCLC that has spread to other parts of the body is often hard to treat. Stage IV SCLC has a relative 5-year survival rate of about 2%. Still, there are often treatment options available for people with this stage of cancer.
For SCLC, it is important to understand that there is some debate about staging, with some doctors believing that the stage I-IV method is not applicable and simply divide patients into those with cancer limited to the lungs (limited) vs. that which has spread to other sites (extensive).
In addition, immunotherapy has only been proven to be effective in treating SCLC in the last couple of years, and 2018 broke new ground as the FDA changed the standard of care for the first time in decades to incorporate it. Therefore, none of that would be captured by these statistics.
Finally, one very important indicator of a patient’s prognosis is his/her response to chemotherapy, which is the most effective treatment for SCLC. People with chemo-sensitive SCLC, particularly those with a complete response (i.e. they achieve a “No Evidence of Disease” / NED state), have a better prognosis. Likewise, while SCLC almost always returns, the longer the period of NED the better the prognosis, as the same treatment will be more likely to be effective at keeping the cancer at bay a second time.
Dayen, Debieuvre, Molinier et al. Journal of Thoracic Disease (Dec. 2017) v.9(12).,
Maneenil, Molina, She et al. Journal of Thoracic Oncology (Jan. 2017) v.12(1).,
Jacoulet, Depierre, Moro et al. Ann Oncol (Oct. 1997) v.8(10).
Xia, Yu, Mao et al. Onco. Targets Ther. (2017) v.10., and