The outlook for patients with stage 4 lung cancer can vary. However, advanced stages of this disease can still be treated to extend life and improve quality of living. Newer treatment options and palliative care approaches can also help patients cope with symptoms. A diagnosis of advanced cancer can bring a lot of emotions to patients and their loved ones, but there are plenty of support resources available to help them find hope in difficult times.
Lung cancer is the leading cause of death in the United States, according to the American Cancer Society. In 2020, the organization reported that there were 1.80 million deaths worldwide from cancer caused by lung disease. While treatment options at earlier stages of the disease can sometimes cure patients, stage 4 lung cancer is typically a terminal condition that is not curable.
This is the most advanced stage of non-small cell lung cancer (NSCLC), also known as adenocarcinoma, when it has spread to one or more other parts of the body, notes the Moffitt Cancer Center in Florida. It may have spread to other areas within the chest, to other parts of the lungs or to distant regions of the body.
NSCLC typically forms due to the accumulation of asbestos fibers in the lungs over time. It is divided into several subtypes, and the prognosis for each depends on the type of cells in the tumor and whether it has mutated. The most common type of NSCLC is the adenocarcinoma that arises from the epithelial lining of the lungs, or pleura.
The other main type of NSCLC is small-cell lung cancer, which tends to grow more rapidly and is generally more aggressive than NSCLC. It is a bit harder to diagnose in early stages, and it is usually diagnosed at a later stage than NSCLC. Small-cell lung cancer is also categorized in subtypes, and its prognosis is different depending on the subtype.
Stage 4 lung cancer has already metastasized to the other organs in the chest and elsewhere in the body. It can be classified in two substages, 4A and 4B. Stage 4A cancer is limited to the lungs, while stage 4B cancer has metastasized to other areas of the body, including the brain, bones, liver and adrenal glands.
When cancer reaches this stage, doctors will generally use palliative treatments to help the patient feel comfortable and reduce pain or other symptoms. Often, this will include low doses of chemotherapy and immunotherapy. Occasionally, doctors may also try to remove the main tumor through surgery. This can be difficult, however, because the tumors are more likely to grow back after surgery than they are to shrink.
The majority of patients with NSCLC at this stage have metastatic disease, meaning that the cancer has already spread from the lungs to other locations in the body, notes Moffitt. Patients with stage 4 metastatic NSCLC have a five-year survival rate of 8 percent. They are usually treated with platinum-based chemotherapy and radiation, as well as tyrosine kinase inhibitor target therapy or immunotherapy.
