Infographic detailing the two types of stage 2 lung cancer, stage 2a and stage 2b, and the differences on the lungs and tumors

What Is Stage II (2) Lung Cancer?

Following a lung cancer diagnosis, doctors use staging systems to describe the size of tumors, whether or not they have spread, and to what extent. With a defined stage, the disease can be properly treated according to its severity. Stage II (2) of lung cancer is still considered an early stage, yet some stage II cancers include metastases to nearby lymph nodes. Today, the standard of care for this stage consists of surgery followed by chemotherapy.

Deaths from lung cancer are the most common among all cancer-caused deaths in the United States. Often, it is a serious illness with the potential to progress quickly. Nonetheless, more and more people are surviving lung cancer diagnoses due to advancements in medical technology and cancer-fighting drugs. There are over 430,000 people living today after receiving a lung cancer diagnosis at some time in their lives. For early-diagnosed lung cancers, in particular, five-year survival rates are increasing.

Early screening for high-risk individuals or annual testing is integral to treating lung cancer. The symptoms of early-stage cancers often feel like a cold. And, because a majority of cases are caused by smoking cigarettes, early signs sometimes go unnoticed. Signs of stage II lung cancer are also hard to detect as lung pathways are large, allowing tumors to grow for some time before causing complications.

Symptoms of stage II lung cancer may include:

  • Chest pain
  • Coughing
  • Difficulty breathing
  • Fatigue

Stage II Non-Small Cell Lung Cancer

Cancers categorized as non-small cell lung cancer (NSCLC) make up approximately 85 percent of cancers beginning in the lungs. Like stage I (1) NSCLC, stage II diagnoses are still early-stage cancers and may be cured by treatment or a combination of treatments. Before this stage, tumors could only be found in one of the lungs. In stage II, tumors are often larger and may have spread to lymph nodes nearby.

Stage II is broken down into two groups based on the size of the original tumor and the spread to lymph nodes closest to the lung. Stage IIA tumors are no larger than five centimeters and are partly blocking an airway, but have not reached any lymph nodes or other areas of the body.

In the TNM system (a system that further details the action of Tumors, Nodes, and Metastases), stage IIA is written as T2b, N0, M0.

Stage IIB tumors are between three and seven centimeters and may be blocking an airway, pressing against the phrenic nerve, or filling membranes of the chest and heart. Additionally, cancerous cells may have started to spread beyond the lungs and to nearby lymph nodes.

Stage IIB may be categorized as T1a/T1b/T1c, N1, M0; T2a/T2b, N1, M0; or T3, N0, M0.

Stage II Small Cell Lung Cancer

Unlike NSCLC, small cell lung cancer (SCLC) does not have an official staging system due to the comparatively low rate of cases – about 15 percent of all lung cancers are classified as SCLC. This form of cancer has only two main stages, limited and extensive-stage cancer. Approximately two of every three SCLC cases are diagnosed in the extensive stage.

Limited-stage SCLC tumors are found in only one lung and, like stage II of NSCLC, may have spread to lymph nodes nearby. While limited-stage SCLC does not include metastases to the other lung or distant organs, these types of tumors grow and spread more quickly than NSCLC.

Prognosis and Survival Rates

A lung cancer prognosis details the likely progression of the disease or its outlook after being diagnosed. Overall, the outlook for lung cancers is generally poor, though prognoses are better for patients diagnosed in the earlier stages of the disease.

New types of treatment are now increasing cure rates and quality years of life. In addition to improving lung cancer prognoses, survival rates for stage II lung cancers are likewise climbing.

Today, the five-year survival rate for localized (i.e., early-stage) NSCLC is 61 percent. The five-year survival rate for localized, or limited, SCLC is 27 percent. Patients undergoing lung cancer treatments now are likely to have higher rates due to advancements in treatment and the time it takes to release new five-year survival reports. Today’s data, for instance, comes from patients diagnosed five years ago.

Stage II Cancer Treatments

Treatment for lung cancer depends on the goals of the patient: curing his or her cancer, alleviating the painful side effects of large tumors, or preventing cancer cells from returning. If the patient is able, stage II tumors are removed via surgery.

The standard of care for stage II NSCLC consists of surgery – typically a form of thoracotomy (opening the chest to remove tumors) – followed by chemotherapy to destroy any remaining cancer cells. For large tumors, radiation or chemotherapy may be used prior to an operation to shrink them.

Some surgical procedures used to remove stage II NSCLC tumors include:

  • Pneumonectomy (removal of the whole lung)
  • Lobectomy (removal of a lobe of the lung)
  • Segmentectomy (removal of a segment of the lung)
  • Video-Assisted Thoracoscopic Surgery (VATS)

If the patient is not healthy enough for surgery (a procedure that generally involves cutting through a rib) or anesthesia, a combination of radiation therapy and chemotherapy may be used to shrink and/or eliminate tumors.

Treating limited-stage SCLC usually differs from treatment for stage II NSCLC in how it addresses the spread of tumors. Consequently, SCLC is more difficult to treat with surgery alone. Chemotherapy and radiotherapy are often administered to SCLC patients (healthy patients may undergo chemoradiotherapy, a procedure that combines the two treatments into one).

Also, some patients are prescribed radiation therapy to the head after treatment. Known as prophylactic cranial radiotherapy (PCR), the goal of the operation is to kill any lingering SCLC cells that may have reached the brain but are too small to appear on imaging scans. A case evaluation can help people who have been diagnosed with lung cancer get up-to-date medical and legal information.