In Singapore, lung cancer is currently the 2nd most common cancer in men and the 3rd most common cancer in women.
There is a reason why it is also known as the “silent killer” – unfortunately, lung cancer is one of the most common diseases that often gets diagnosed too late when cancer cells have spread to other parts of the body.
To help determine the best course of treatment, doctors will first determine the stage of lung cancer based on factors such as the tumour size and whether or not cancer is found in the lymph nodes or other parts of the body. This guide will hopefully clarify the details on how late-stage lung cancer is diagnosed and possible treatment options.
Stages of lung cancer
There are primarily two types of lung cancer, namely, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Each type is labelled differently.
The stages for NSCLC proceed from 1 to 4:
Stage l: The cancer is only located in the lungs and hasn’t spread to nearby lymph nodes.
Stage ll: The cancer is larger (more than 3cm), or has spread to some nearby lymph nodes.
Stage lll: The cancer is very large (more than 7cm), or has spread to nearby tissues or the lymph nodes.
Stage IV: Cancer has spread to both lungs or fluids around the lungs, or other organs outside the lungs, such as the brain or liver.
Stage IV NSCLC is further divided into 2 substages:
Stage IVA: Cancer has spread within the chest and/or has spread to 1 area outside of the chest.
Stage IVB: Cancer has spread outside of the chest to more than 1 place in 1 organ or more than 1 organ.
In the case of SCLC, the cancer is further divided into limited or extensive stages:
Limited: Somewhat similar to NSCLC stage 4, cancer is only in the chest.
Extensive: Cancer has spread outside the chest.
It's important to understand your cancer stage because this will help the lung cancer specialist decide which treatment will work best. For instance, lung cancer early-stage treatment may call for surgery while late-stage lung cancer focuses more on radiation and chemotherapy. Treatment options for late-stage lung cancer
Unfortunately, late-stage lung cancer is often incurable. Approximately 57% of all lung cancers have spread outside of the chest by the time a doctor diagnoses the condition2. Thus, the goal of late-stage lung cancer treatment is to control the growth and spread of cancer, relieve any symptoms and extend life for as long as possible. There are 5 main treatments for lung cancer:
Surgery: to remove the tumour and affected lymph nodes.
Chemotherapy: to kill cancer cells. Often used before or after surgery.
Radiation therapy: to kill cancer cells and shrink tumours. The treatment only affects cells in the target area and can be used to control symptoms.
Targeted therapy: limit and control the growth and spread of cancer cells
Immunotherapy: medications called checkpoint inhibitors are taken to stimulate your immune system to target and attack lung cancer cells.
Advanced lung cancers are most often treated with chemotherapy, targeted therapies and immunotherapy as surgery is often not an option. Immunotherapy, in particular, is a very promising treatment for late-stage lung cancer.
Palliative care is also a common part of treatment for late-stage lung cancer, with a huge focus on relieving pain and improving the quality of life of the patient including offering emotional and moral support. Late-stage lung cancer is not a death sentence As compared to 10 years ago, the outlook for lung cancer is much better, even in advanced stages. Although the 5-year relative survival rate for late-stage NSCLC lung cancer is about 6% as compared to only 3% for SCLC3, cancer screening tests can help in early detection and diagnosis to improve the chances of survival and treatment outcomes. Having late-stage cancer affects a person physically, mentally, and emotionally. Seeking the right support is vital – ICS is a cancer treatment centre that is managed by a multidisciplinary team who will work together to provide the best possible treatment and care. Get in touch with us at +65 6235 9005 to arrange an appointment with our doctors. References
1. Lung Cancer - NCIS | National University Cancer Institute, Singapore. Retrieved 22 September 2021, from https://www.ncis.com.sg/Cancer-Information/About-Cancer/Pages/Lung-Cancer.aspx
2. Cancer of the Lung and Bronchus - Cancer Stat Facts. Retrieved 22 September 2021, from https://seer.cancer.gov/statfacts/html/lungb.html
3. Lung Cancer Survival Rates | 5-Year Survival Rates for Lung Cancer. (2021). Retrieved 22 September 2021, from https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/survival-rates.html