Introduction

The prognosis for lung cancer is the disease's expected course, which helps one understand how their cancer is likely to progress and what treatment options are available to them.

Overall survival rates can vary greatly depending on the cancer type, stage at diagnosis, general health, and how well the treatment works. Some patients with early-stage lung cancer may receive treatment that aims to cure the cancer, whilst others may need long-term treatment to control the cancer.

Whilst survival rates can provide useful information, it is impossible to know exactly how long someone will live. There are now many advances in treating cancer.

What is lung cancer prognosis?

Prognosis for lung cancer is an estimate given by medical professionals based on what is known about the cancer and the patient. Physicians will consider several parameters, including the size of the cancer, whether it has progressed to lymph nodes, if it has moved to other parts of the body, the type of cancer, and the results of molecular testing.

Early diagnosis can help improve treatment success as the cancer may still be present in the lung. If the cancer has spread to other parts of the body, treatment will aim to control the cancer.

However, prognosis isn’t solely based on cancer staging. Some late-stage cancers respond well to targeted treatment and immunotherapy, helping patients live longer than previously thought.

What are the survival rates for lung cancer stages?

Relative five-year survival rate refers to the likelihood that the individual will live five years beyond the diagnosis with a particular form of cancer, compared with the overall population.

Based on data from the US National Cancer Institute (SEER) for diagnoses between 2016-2022, lung & bronchus cancer had an overall five-year relative survival rate of around 29.5%.

Cancer extent — Five-year relative survival rate

• Localized: Cancer is only in the original area — 65.5%
• Regional: 38.2% of cancer cases have spread to neighboring lymph nodes or other sites.
• Distant - Cancer has spread to distant organs — 10.5%
• Overall - 29.5%

[Note: The survival rates shown are based on SEER summary stages and not the actual exact stages (I, II, III and IV). The rates include large numbers of patients in the USA and may not reflect the survival rates in all countries or for individual patients.]

What are the survival rates by lung cancer type?

Lung cancer is one of the two categories of cancers, which includes non-small cell lung cancer and small cell lung cancer. These cancers differ in growth and reaction to treatment.

Non-Small Cell Lung Cancer

Lung cancer can be broadly categorized as non-small cell lung cancer, which consists of squamous cell carcinoma, adenocarcinoma, and other rare types of lung cancers.

Based on data from the USA, the American Cancer Society reports the following survival rates for non-small cell lung cancer:

• Localized - ~67%.
• Regional - ~40%.
• Distant - ~12%.
• Overall - ~32%.

This highlights why early detection is so important. However, each patient will be different depending on tumor characteristics, treatment, and general health.

Small Cell Lung Cancer

Small cell lung cancer is rare and often grows and spreads more quickly. Treatment will often involve chemotherapy and immunotherapy. Radiotherapy will also be used where appropriate.

The following are the survival rates for small cell lung cancer, according to statistics from the American Cancer Society:

• About 34% are localized.
• About 20% is regional.
• Distant: about 4%.
• Overall: about 9%.

Note: The data may not accurately reflect the effects of more recent treatments because it is based on diagnoses made between 2012 and 2018.

Data from the American Cancer Society for both cancer types.

What factors affect lung cancer survival?

Many factors can affect how lung cancer develops and how well someone may respond to treatment.

• Cancer Stage: One of the most important factors is the stage of the cancer. If the cancer hasn’t spread outside the lung, then surgery or other treatments may be appropriate to remove the cancer. Treatment will be administered systemically if the cancer has spread to distant organs.
• Cancer Type & Characteristics: There are different subtypes of lung cancer. Molecular testing can help identify any genetic changes in the tumor, such as EGFR or ALK mutations. This can help with targeted treatments for some tumors. Tumor characteristics can also help doctors decide if immunotherapy would be appropriate.
• General Health & Age: A patient's general health, lung function, other medical problems, and tolerance to treatment can influence what treatment options are available. Age won’t necessarily determine whether treatment will help.
• Tumor Response to Treatment: Some tumors will respond very well to treatment and shrink. Others may not change much. Doctors will monitor how well the cancer is responding using symptoms, exams, and scans. Adjustments will be made if required.
• Smoking & General Health: Giving up smoking can improve general health. Managing your diet, physical activity and other medical problems can help.

Can lung cancer be Cured?

Sometimes lung cancer can be cured. This will often depend on how early it is diagnosed and if it can be fully removed or treated with radiotherapy.

One of the treatment methods for non-small cell lung cancer that is diagnosed at an early stage is surgery. Depending on the circumstances, targeted therapy, immunotherapy, or chemotherapy may also be employed.

Some locally advanced patients can also receive treatment with the intention to cure. Metastatic lung cancer is less likely to be fully cured; however, treatment may control it for a long period of time.

Whether lung cancer can be cured will depend on the cancer type, stage, tumor characteristics, and how well it responds to treatment. You should discuss realistic treatment aims with your oncology team.

How can patients improve quality of life?

Whilst you can’t control everything that affects prognosis, there are several things you can do to help you cope with treatment.

• Stick to your treatment plan - attend appointments and investigations, and discuss any side effects with your healthcare team.
• Give up smoking - improving your health by giving up smoking.
• Eat enough - eating a healthy, balanced diet can help with treatment.
• Be physically active - gentle exercise can help reduce tiredness.
• Talk to someone - counseling, support groups, and family members can help.
• Talk to someone about palliative care - supportive/palliative care can help with pain, breathlessness, tiredness and other symptoms. This can be done alongside cancer treatment.

Always speak to your medical team before making any big changes to your diet, exercise, supplements or medication.

Conclusion

Lung cancer prognosis and survival rates depend on many factors such as cancer stage, type, molecular characteristics, general health and how well it responds to treatment. Survival rates tend to be better if cancer is caught early rather than when it has spread. However, you can’t be sure how long someone will live.

There are many treatments available to treat lung cancer depending on your condition: targeted therapy, immunotherapy, chemotherapy, surgery and radiotherapy. Seeing a specialist, understanding your diagnosis and discussing treatment can help you make informed decisions.

Each patient's experience will be different, and the best estimate of prognosis is to discuss your individual test results and treatment options with your oncologist.

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