Stage 3 Non-Small Cell Lung Cancer Diagnosis, Treatment and Payment Information

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Overview

Stage 3 Non-Small Cell Lung Cancer (NSCLC) diagnosis is divided into Stages 3A, 3B & 3C.

Tap “Watch Now” for an easy-to-understand overview of Stage 3 Non-Small Cell Lung Cancer; then compare the treatment options side-by-side.

Stage 3A Lung Cancer
Stage 3B Lung Cancer
Stage 3C Lung Cancer
Understanding EGFR & PD-L1

Stage 3A (1)

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Stage 3A NSCLC diagnosis is when the tumor has spread to the lymph nodes around the main airway called the trachea or near the carina, AND:

1. The tumor is 5 centimeters or less

2. One or more of the following has happened:

The lung cancer has spread to the inner lining of your lung.
The lung cancer has spread into your bronchus but not where the main airway branches an area called the carina.
One of the lungs has collapsed or has an inflammation as shown at the bottom of the image.

What Tests Will I Need and Why?

Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.

Tissue Analysis is also typically done to determine if the cancer cells have any specific biomarkers which are critical to finding the best treatment option for you.

In Stage 3 NSCLC, doctors look for an EGFR Mutation and /or an elevated PD-L1 level.

If your treatment team has not already performed tests to determine your cancer’s features, please ask your doctor when these tests will be performed.

Re-read this summary as needed and then tap, “Compare My Treatment Options Now“. Our unique Comparison Page will help you understand your FDA-approved treatment options including, who can help you pay for your treatment, where and how each is given and what side-effects you may experience.

Stage 3A (2)

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The lung cancer has spread to the lymph nodes on the same side your primary cancer and the affected lymph nodes are either in the lung tissue or near the airways AND:

1. The tumor is more than 5 centimeters but less than 7 centimeters.

or one or more of the following:

You have more than one tumor on the same segment (lobule) of the lung as the primary tumor.
The tumor is affecting the chest wall.
The tumor is affecting a nerve in the diaphragm, called Phrenic Nerve.
The tumor is affecting the lining of your chest wall (parietal pleura).
The tumor is affecting the lining that surrounds the heart (pericardium).

Stage 3A (3)

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The tumor is larger than 7 centimeters and/or one or more of the following has happened:

There are more tumors in the same lung, but in different segments (lobules).
The tumor affects the diaphragm, the space between the lungs (mediastinum), the heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral bones or the carina.

Lymph nodes on the same side as the primary tumor may or may not be affected at this stage.

National Institute of Health/ treatment-lung

Stage 3B Lung Cancer (1)

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Stage 3B (1) NSCLC diagnosis is when the tumor has spread to the lymph nodes on the opposite lung or above the collarbone, AND:

The tumor is 5 centimeters or less or, one or more of the following has happened:

The lung cancer has spread to the inner lining of your lung.
The lung cancer has spread into your bronchus but not where the main airway branches an area called the carina.
One of the lungs has collapsed or has an inflammation as shown at the bottom of the image.

What Tests Will I Need and Why?

Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.

Tissue analysis is also typically done to determine if the cancer cells have any specific biomarkers which are critical to finding the best treatment option for you.

In Stage 3 NSCLC, doctors look for an EGFR Mutation and an elevated PD-L1 level.

If your treatment team has not already performed tests to determine your cancer’s features, please ask your doctor when these tests will be performed.

Stage 3B Lung Cancer (2)

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The tumor has spread to the lymph nodes around the main airway called the trachea or near the carina, and:

1. The tumor is more than 5 centimeters but less than 7 centimeters.

And/or

2. One or more of the following:

You have more than one tumor on the same segment (lobule) of the lung as the primary tumor.
The tumor is affecting the chest wall, a nerve in the diaphragm, called Phrenic Nerve, the lining of your chest wall (parietal pleura) or the lining that surrounds the heart (pericardium).

The tumor is larger than 7 centimeters and/or

One or more of the following has happened:

There are more tumors in the same lung, but in different segments (lobules).
The tumor affects the diaphragm, the space between the lungs (mediastinum), the heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral bones or the carina.

What Tests Will I Need and Why?

Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.

Tissue analysis is also typically done to determine if the cancer cells have any specific biomarkers which are critical to finding the best treatment option for you.

In Stage 3 NSCLC, doctors look for an EGFR Mutation and an elevated PD-L1 level.

If your treatment team has not already performed tests to determine your cancer’s features, please ask your doctor when these tests will be performed.

National Institute of Health/ treatment-lung

Overview

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Stage 3C Non-Small Cell Lung Cancer diagnosis is when the tumor has spread to the lymph nodes on the opposite lung or above the collarbone, AND:

1. The tumor is more than 5 centimeters but less than 7 centimeters and/or,

2. One or more of the following:

You have more than one tumor on the same segment (lobule) of the lung as the primary tumor.
The tumor is affecting the chest wall, a nerve in the diaphragm, called Phrenic Nerve, the lining of your chest wall (parietal pleura) or the lining that surrounds the heart (pericardium).

or,

The tumor is larger than 7 centimeters and/or,

One or more of the following has happened:

There are more tumors in the same lung, but in different segments (lobules).
The tumor affects the diaphragm, the space between the lungs (mediastinum), the heart, great vessels, trachea, recurrent laryngeal nerve, esophagus, vertebral bones or the carina.

What Tests Will I Need and Why?

Blood and Imaging tests are done to understand your general health, confirm your diagnosis and determine your cancer stage.

Tissue analysis is also typically done to determine if the cancer cells have any specific biomarkers which are critical to finding the best treatment option for you.

In Stage 3 NSCLC, doctors look for an EGFR Mutation and an elevated PD-L1 level.

If your treatment team has not already performed tests to determine your cancer’s features, please ask your doctor when these tests will be performed.

National Institute of Health/ treatment-lung

Identifying Biomarkers is critical to determining the best treatment option for you

In addition to the size and cancer stage, your lung cancer treatment options will be guided by biomarkers. Biomarkers are found in your body’s tissues or fluids. For people with Stages 1-3 NSCLC, EGFR and PD-L1 are the most common biomarkers.

EGFR-positive

EGFR (Epidermal Growth Factor Receptor) is a protein that helps your body with healthy cell growth. A mutation or abnormal change in your body’s EGFR gene can cause excessive cell growth and cancer.

There are different types of EGFR mutations that doctors look for including EGFR 19 deletion, EGFR L858R and EGFR exon 20 insertion. About 10-15% of patients with Lung Cancer have an EGFR mutation. EGFR L858R is the most common type.

If you test positive for EGFR, your treatment typically includes a medication to block EGFR, called TKI or a Tyrosine Kinase Inhibitor.

PD-L1

PD-L1 is a protein that is found in healthy cells and acts as a “brake” to keep your immune system from attacking your body’s non-harmful cells. Some cancer cells “trick” the immune system to not turn on and therefore avoid being attacked.

If your tests show cancer cells with a high level of PD-L1 ( > than 50% of the cells have PD-L1), you may benefit from immunotherapy, a treatment type that takes the “brakes” off your immune system so it will recognize and attack the cancer.

Immunotherapy is only helpful when patients do not have any other mutation such as EGFR or ALK. These patients benefit from Targeted Therapy.