Adenocarcinoma lung stage 4 refers to cancer that has spread from its primary site in the lungs to other parts of the body. At this point, doctors can no longer remove the cancer entirely. However, treatment can help control the cancer’s progression and improve symptoms. Lung adenocarcinoma that has spread to the brain, liver or adrenal gland is still considered lung cancer. The same is true for pleural mesothelioma, which is a form of cancer that develops on the lining of the lungs and is caused by asbestos exposure.
This man’s adenocarcinoma lung stage 4 was diagnosed after he had a CT scan of his chest and an MRI. He is currently asymptomatic, but has had other lung problems for years that he did not seek medical attention for. His ECOG performance status is 1, meaning that he can perform most everyday activities.
In general, most people with stage IV non-small cell lung cancer have systemic treatments to treat all sites of the cancer. These are typically combined with radiation therapy and/or chemotherapy, depending on the specific type of lung cancer.
Because of the extent of the cancer at this point, surgery is not usually an option. If a person is healthy enough for surgery, they may have the cancer removed with a procedure called lobectomy or sleeve resection. This involves removing part of the lung and often some lymph nodes. Sometimes the whole lung is removed (pneumonectomy). Depending on the location and extent of the tumor, other surgical options could include stereotactic body radiation therapy or radiofrequency ablation.
For most people with stage IV lung cancer, however, removing the cancer is not possible. In addition, the cancer has likely spread to vital structures in the chest, such as large blood vessels and the main breathing tubes leading to the lungs. This makes surgery too risky.
If a person has a small area of cancer that has spread to the adrenal gland or the brain, a combination of surgery and chemoradiation may be an option. In some cases, immunotherapy drugs like durvalumab (Imfinzi) may be given for up to a year to keep the cancer under control.
Although the prognosis is poor, people at this stage of lung cancer are living longer than ever before. Survival rates vary greatly, though, as everyone responds to the disease and its treatment differently. Also, the survival rates cited in this article are based on results from diagnosis and treatment that took place 5 or more years ago. Newer treatment options are continually being researched and improved upon.
