Cancer Research Lab

Remember – statistics are averages based on large numbers of patients. They cannot predict exactly what will happen to you. No two patients are exactly alike and response to treatment also varies from one person to another.

You should feel free to ask your doctor about your prognosis, but not even your doctor can tell you for sure what will happen. You may hear your doctor use the term ‘5 year survival’. It does not mean you will only live 5 years! It relates to the proportion of people in research studies who were still alive 5 years after diagnosis. Doctors follow what happens to people for 5 years after treatment in any research study. This is because, for many types of cancer, if it has not come back within 5 years, it is not likely to come back at all. Unfortunately, lung cancer can sometimes come back more than 5 years after it has been treated. But the figures are still based on the 5 year follow up.

Outcome overall and by stage

As with many other types of cancer, the outcome depends on how advanced your cancer is when it is diagnosed. In other words, the stage of your cancer. Lung cancer is one of the most difficult cancers to treat and is often diagnosed in very late stages. Because of these factors, lung cancer has one of the lowest survival outcomes of any type of cancer.

With lung cancer the likely outcome will also depend very much on the type of lung cancer that you have. The statistics for small cell lung cancer are different from the statistics for non-small cell lung cancer. So we have presented them separately below.

Overall, of all those people diagnosed with all types of lung cancer at all stages, only about 20 out of every 100 people (20%) will live for at least 1 year after diagnosis. About 6 out of every 100 people diagnosed (6%) will live for at least 5 years after diagnosis. And about 5 out of every 100 will live for at least 10 years.

For those who are able to have surgery to remove their cancer, about 20 out of 100 (20%) are alive 5 years later.

Non small cell lung cancer
There are 4 main stages for non small cell lung cancer.

Stage 1
This is the earliest stage and so has the best outcome. Depending on where the cancer is, it is often possible to remove stage one lung cancer with surgery. Unfortunately, it is not all that common for lung cancer to be diagnosed this early. Stage 1 non small cell lung cancer is often divided into 2 stages, stage 1A and 1B.

Of all those people with stage 1A non small cell lung cancer treated with surgery, about 80 out of every 100 (80%) will be alive 5 years later.

Of all those with stage 1B non small cell lung cancer treated with surgery, about 60 out of every 100 (60%) will be alive 5 years later.

Stage 2
Of all those people diagnosed with stage 2 non small cell lung cancer who have been treated with surgery, between 40 and 50 out of every 100 people (40 – 50%) will be alive 5 years later.

Stage 3
As you might expect, the survival statistics fall with these more advanced stages of lung cancer. The rates for stage 3 vary, depending on the type of treatment you are able to have. And the treatment you have depends on the extent of your cancer.

Some people with stage 3 non small cell lung cancer can still have surgery. Of these people, between 25 and 30 out of every 100 people (25 – 30%), will be alive 5 years later.

For people who have stage 3 including cancer in the lymph nodes of the chest (mediastinum) and neck, radiotherapy and chemotherapy are the main treatments. For those who have radiotherapy only, between 5 and 10 out of every 100 people (5 – 10 %) will be alive 5 years later.

If people with stage 3, including cancer in the chest and neck nodes, are able to have chemotherapy as well as radiotherapy, there is a slightly better outcome. Between 7 and 17 out of every 100 people (7 -17%) will be alive 5 years later.

Stage 4
Stage 4 is the most advanced stage, where the cancer has spread. Understandably, the survival statistics are lowest for this stage. Unfortunately, lung cancer is often diagnosed late. Almost half of all those diagnosed with non small cell lung cancer already have stage 4 disease.

People diagnosed at this stage are mostly treated with chemotherapy to relieve symptoms. Between 15 and 35 out of every 100 people (15 – 35%) treated for stage 4 lung cancer will be alive a year later. For those not fit enough to have chemotherapy treatment, this figure drops to about 10 out of every 100 people (10%).

On average, only about 2 out of every 100 people (2%) diagnosed with stage 4 non-small cell lung cancer would be alive 5 years later.

Small cell lung cancer
Small cell lung cancers are less common than non small cell cancers. There are often just two stages for small cell lung cancer

Limited disease and Extensive disease
This is because this type of cancer usually grows and spreads quite quickly. Of all those diagnosed with small-cell lung cancer, around 1 in 3 have limited disease at the time of diagnosis. 2 out of 3 already have extensive disease at the time of diagnosis.

Of those people who have limited disease and have chemotherapy, between 35 and 40 out of every 100 people (35 – 40%) will be alive 2 years later.

People with extensive disease are also treated with chemotherapy. But unfortunately, the survival rate is even lower. Most only survive another 10 to 12 months.

Chemotherapy does do quite a bit to extend survival time for many people. Without treatment, very sadly, survival time is often a matter of weeks.

Overall health
Another factor that can affect your prognosis, apart from the stage of your cancer, is how well you are overall. Doctors call this your ‘performance status’. A score of 0 means you are completely able to look after yourself. A score of 1 means you can do most things for yourself, but need some help. The scores continue to go up, depending on how much help you need.

For example, if you are weak from losing weight, pain and feel very tired, you will need more day to day help, so your performance score will be at least 1. You may see performance status written ‘PS’.

How reliable are cancer statistics?
No statistics can tell you what will happen to you. Your cancer is unique. The same type of cancer can grow at different rates in different people for example.

The statistics are not detailed enough to tell you about the different treatments people may have had. And how that treatment may have affected their prognosis. Chemotherapy, surgery and radiotherapy may help people to live longer as well as relieving symptoms. There are many individual factors that will determine your treatment and prognosis. If you are fit enough to have treatment, you are likely to do better than average, particular if your cancer is more advanced.

Clinical trials
People treated at centres where clinical trials are taking place tend to do better. This is almost certainly because that is where the most expertise is concentrated – research is more likely to take place in specialist centres. For those in the trials, it may be partly to do with having a closer eye kept on them by their doctors than they might if not in a trial – more scans and blood tests for example. But it might also be something to do with morale. You may feel more positive if you are taking part in a trial because it is more obvious to you that something is being done to help you. There is more about understanding clinical trials in CancerHelp UK. To search our clinical trials database for trials that are recruiting for lung cancer, click on the blue ‘clinical trials button’ to the left of your screen and pick ‘lung’ from the drop down menu of cancer types.

Source: Cancer Research UK