Key takeaways
- Stage 1 lung cancer means that there is non-small cell lung cancer (NSCLC) with a tumor no larger than 4 centimeters that has not spread to lymph nodes or distant organs.
- Stage 1 lung cancer usually does not cause symptoms, which is why most cases are not diagnosed until later stages when symptoms like coughing, shortness of breath, or chest pain appear.
- Treatment typically involves surgery to remove the cancerous part of the lung, and the 5-year relative survival rate for localized NSCLC is 65.5%. If there is a high risk of recurrence, a doctor may recommend chemotherapy after surgery.
Cancer stages provide information about how large the primary (original) tumor is and whether it has spread to local or distant parts of the body.
Most types of cancer, including non-small cell lung cancer (NSCLC), are assigned number stages. NSCLC is one of the two major types of lung cancer. The other is small cell lung cancer (SCLC).
NSCLC is staged from 0 to 4. If the number is low, then it means the cancer has not spread very far.
SCLC only has two cancer stages: limited and extensive. Number stages are not used for SCLC. If a doctor diagnoses you with stage 1 lung cancer, then it means you have NSCLC. NSCLC is less aggressive than SCLC — and much more common.
In stage 1 lung cancer, the primary (original) tumor is no larger than 4 centimeters (cm). In addition, the cancer cells have not spread to the lymph nodes or distant parts of the body (such as other organs).
The TNM system is used to help categorize lung cancer:
- T indicates the size and other features of the primary tumor.
- N indicates if the cancer has reached the lymph nodes.
- M indicates if the cancer has metastasized, or spread, to other parts of the body.
Once the TNM categories are assigned, the overall stage can be determined.
Stage 1 lung cancer is divided into four substages, according to the
- Stage 1A1: There are two scenarios where a doctor may diagnose stage 1A1 lung cancer:
- The tumor is 1 cm or smaller.
- The tumor is an adenocarcinoma, which originates in lung cells that make mucus. It’s 3 cm or smaller. No more than 0.5 cm of the adenocarcinoma has moved into deeper lung tissues.
- Stage 1A2: The tumor is between 1 cm and 2 cm.
- Stage 1A3: The tumor is between 2 cm and 3 cm.
- Stage 1B: A doctor may diagnose stage 1B lung cancer if at least one of the following statements applies:
- The tumor is between 3 cm and 4 cm.
- The tumor has grown into one of the two main bronchi (airways), but it’s at least 2 cm away from the carina (the cartilage that divides the bronchi). The tumor is no larger than 4 cm.
- The tumor has grown into the visceral pleura, the membrane that covers the lung. The tumor is no larger than 4 cm.
- The tumor is partially blocking the airways, but it’s no larger than 4 cm.
The table below lists the TNM stage grouping for each stage.
| Stage of lung cancer | TNM combination |
|---|---|
| Stage 1A1 | T1miN0M0 (for an adenocarcinoma) |
| Stage 1A1 | T1aN0M0 (for a tumor no greater than 1 cm) |
| Stage 1A2 | T1bN0M0 |
| Stage 1A3 | T1cN0M0 |
| Stage 1B | T2aN0M0 |
Stage 1 lung cancer does not usually cause symptoms.
If you experience any early symptoms, they may be mild. In the early stages of lung cancer, symptoms can include:
Contact a doctor if you have any concerns. This is especially crucial if you smoke or have other risk factors for lung cancer,
Symptoms of advanced cancer
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Symptoms of NSCLC can come on slowly for some people. According to a 2019 article, the median doubling time for NSCLC is 230 days. The doubling time refers to how long it takes the tumor to double in size.
Later-stage lung cancer may lead to symptoms such as:
Early detection helps make treatment more effective. Routine screenings can help with early detection.
The U.S. Preventive Services Task Force (USPSTF) recommends annual screening with a low dose CT scan for people who meet all of the following criteria:
- They are between the ages of 50 and 80.
- They have a history of at least 20 pack-years, which are years in which they smoked an average of 20 cigarettes (or one pack) per day.
- They currently smoke or have quit in the last 15 years.
A low dose CT scan exposes you to less radiation than a traditional CT scan. It’s also more accurate than a chest X-ray, which was previously used to help screen for lung cancer.
Your
- the type of lung cancer you have
- which genetic mutations are involved
- your general health, including other medical conditions
- your age
Once you finish treatment, it will take some time to fully recover. Afterward, you’ll still need regular checkups and follow-up testing so your doctor can look for evidence of recurrence. Recurrence is cancer that comes back after you’ve had treatment and were considered to be cancer-free.
Surgery
You
If you’re at high risk of recurrence, your doctor may recommend chemotherapy after surgery.
Chemotherapy involves the use of powerful drugs that can destroy cancer cells near the surgical site or those that may have broken free of the original tumor. For people with NSCLC, it’s usually administered intravenously (IV) in cycles of
If surgery is not a suitable option for you, radiation therapy or radiofrequency ablation may be used as your primary treatment.
Radiation therapy
Radiation therapy uses high-energy X-rays to kill cancer cells.
It’s a painless procedure that’s typically performed
Radiation therapy is also sometimes used as a secondary treatment to destroy cancer cells that may have been left behind after surgery.
Radiofrequency ablation
Radiofrequency ablation can be performed under local anesthesia as an outpatient procedure.
Did you know?Targeted drug therapies and immunotherapies are generally reserved for later stage or recurrent (returning) lung cancer.
Symptom management
In addition to treating the lung cancer, your doctor can help treat individual symptoms.
There are a variety of medications to help control coughing, such as cough syrups. It may also be necessary to treat any underlying conditions that may be contributing to your cough.
There are also a few things you can do on your own when you feel short of breath:
- Change your positioning: Leaning forward makes it easier to breathe.
- Concentrate on your breathing: Focus on the muscles that control your diaphragm. Purse your lips and breathe in rhythm.
- Try to relax: Anxiety can add to the problem, so choose a relaxing activity such as listening to your favorite music or meditating to keep calm.
- Take a break: If you try to power through, you’ll overexert yourself and make matters worse. Save your energy for the most important tasks, or ask someone else to pitch in when possible.
The
The SEER database does not group cancers according to the TNM system. Instead, it groups lung and bronchus cancers into these three stages:
- Localized: Cancer is limited to one lung.
- Regional: Cancer has moved from the lung to nearby lymph nodes or other nearby parts of the body.
- Distant: Cancer has spread to the other lung or other distant parts of the body.
Stage 1 lung cancer is considered localized. The 5-year relative survival rate, based on statistics from 2016 to 2022, is
The relative survival rate is used to compare people with the same cancer type and stage to people in the population at large. This means that people with localized NSCLC are, on average, 65.5% as likely as people without NSCLC to live for at least 5 years after their cancer diagnosis.
The three major forms of NSCLC are:
- adenocarcinomas
- squamous cell carcinomas
- large cell carcinomas
The relative survival rates may be higher for people with
Making sense of survival rates
Survival rates are only estimates, and your experience will be unique. Survival rates can be confusing, so speak with your doctor about your specific circumstances.
Your individual outlook will depend on many things, such as:
- the particular type of lung cancer you have, including which genetic mutations are involved
- whether you have other serious health conditions
- the treatments you choose and how well they work for you
A 2025 article explains that previous literature has reported NSCLC recurrence rates as anywhere from 20% to 55%. It also notes that advancements in screenings can help reduce the likelihood of recurrence.
Your doctor will schedule follow-up testing for you well after you finish treatment. In addition to a physical examination, you might need periodic imaging tests and blood tests so your doctor can monitor any changes.
Contact your doctor if you experience any of the following symptoms of recurrence:
- hoarseness
- shortness of breath
- new or worsening cough
- coughing up blood
- wheezing
- chest pain
- unexplained weight loss
Other symptoms may appear depending on where the cancer has recurred. If you’re experiencing new or unusual symptoms, tell your doctor right away.
You may find that you’re able to manage better if you take an active role in your own care. It’s a good idea to partner with your doctor and stay informed.
You can ask about the goals of each treatment, as well as potential side effects and how to manage them. You can also ask about any potential clinical trials, as research is making strides. Be clear about your own wishes.
You do not have to manage lung cancer alone. Your family and friends probably want to be supportive but do not always know how. That’s why they might say something like, “Let me know if you need anything.” Take them up on the offer by making a specific request. This could be anything from going with you to an appointment to cooking a meal.
Do not hesitate to reach out for additional support from:
- social workers
- therapists
- clergy
- support groups
Your oncologist or treatment center can refer you to resources in your area.
For more information about lung cancer support and resources, visit:
You can also connect with people through forums and blogs.
Stage 1 lung cancer refers to early stage non-small cell lung cancer (NSCLC). This is when the tumor is no larger than 4 cm, and the cancer has not spread to other parts of the body.
Early diagnosis is key. Routine screenings can help, particularly as stage 1 cancer does usually cause symptoms until it reaches its later stages.
If you’re at risk of lung cancer or if you have symptoms associated with the condition, make an appointment with a doctor. The low dose CT scan is more effective at detecting early cancer than diagnostic tools used in the past.