What is the prognosis for stage 4 lung cancer?

Life expectancy

The two main types of lung cancer are NSCLC and SCLC, and the causes, outlook, and treatment options will depend on the type.

Many people do not learn that they have lung cancer until the disease is in its later stages. By stage 4, cancerous cells have spread beyond the lung where the cancer initially developed. Late-stage lung cancer can be difficult to treat. Various factors influence a person’s life expectancy estimate following a lung cancer diagnosis. These include:

• the type of lung cancer
• the number of tumors in the lung
• any other lung problems, such as a collapsed lung or fluid buildup
• whether or to what extent the cancer has spread
• any weight loss before the diagnosis
• the ability to perform daily tasks

The ACS notes the following outlooks, based on figures from 2012–2018. It is worth noting however, that as treatment advances, the numbers can change.

For SCLC:

For NSCLC:

Treatment may extend life expectancy, but some options can cause unpleasant side effects that may undermine a person’s quality of life.

For this reason, some people choose to manage their lung cancer with palliative techniques. These focus on treating the pain without prolonging life.

What is stage 4 lung cancer?

There are five stages of lung cancer, ranging from 0 to 4.

Stages 0 and 1 are easier to treat, and people with these types typically have better outlooks than people with lung cancer in stages 2, 3, or 4.

For this reason, a doctor determines the stage of a person’s cancer before discussing their outlook. There are different staging systems, but healthcare providers most often use the TNM system:

• “T” stands for “tumor.” This factor refers to the size of a tumor and whether it has grown into any nearby structures or organs.
• “N” stands for “nodes.” This refers to whether the cancer has spread to any lymph nodes.
• “M” stands for “metastasis.” This refers to whether the cancer has spread to distant structures or organs within the body.

Many people do not learn that they have lung cancer until it is in stage 4. By this stage, the cancer has spread beyond the site where it first developed, and the treatment options are generally more intense and less effective.

Symptoms

Many people with lung cancer do not experience symptoms until the later stages of the disease.

Common symptoms include:

• chest pain
• shortness of breath
• coughing up blood or rust-colored phlegm
• a persistent cough
• hoarseness
• a loss of appetite
• unexplained weight loss
• fatigue
• weakness
• persistent lung infection

Stage 4 lung cancer has spread to the other lung or to other parts of the body. This can cause secondary symptoms. For instance, if cancer spreads to the liver, the person may experience yellowing of the eyes, skin, and nails.

Treatment

There is currently no cure for stage 4 lung cancer, but treatment can relieve symptoms and prolong a person’s life.

However, people with low general health may have difficulty coping with cancer treatment. In this case, the doctor may recommend smaller doses of therapy or treatments that target specific symptoms.

Treating NSCLC

Treatment options available for stage 4 NSCLC include:

• radiation therapy
• chemotherapy
• targeted or molecular therapy
• internal endoscopic radiation

Treating SCLC

The initial treatment for advanced SCLC is typically chemotherapy alongside immunotherapy medication. If the body responds well, the doctor may suggest following chemotherapy with chest radiation.

Palliative care

Palliative care does not target cancer directly. Instead, it aims to address the person’s quality of life and address physical, emotional, and social needs.

Palliative care does not extend life expectancy, but it can enhance a person’s quality of life. The World Health Organization (WHO) reports that palliative care strategies can help ease the distress of late-stage cancer.

What to expect as a caregiver

A person who provides care for someone with a chronic illness may be their spouse, family member, or friend, or they may provide paid assistance.

Being a caregiver can be physically demanding and emotionally challenging. It can also be rewarding to see the difference that providing care makes to the person’s life.

A caregiver may also find that they are providing emotional support, not only to the person whom they are caring for, but also to the person’s family and friends.

Caregivers may feel anxious, depressed, or emotionally exhausted. It is important that they also eceive care and support.

Living with late-stage cancer

A diagnosis of late-stage cancer affects a person mentally and emotionally.

People who are approaching the end of their lives may experience fear of dying. Identifying the specific element of death that is frightening and taking steps to address it may make the fear easier to cope with.

People with late-stage cancer may also feel lonely as if no one else around truly understands their experience. A person who feels this way should consider opening up to a healthcare professional who has experience talking with people who have late-stage cancer. These doctors and nurses, for example, are likely to have a deeper understanding of the experience.

The American Cancer Society observes that regret is another common emotion toward the end of life. Stepping away from thinking about the past can be difficult. It can help to identify and focus on priorities in the present and write letters or make recordings for loved ones to treasure later on.

However, having late-stage cancer makes a person feel that speaking about these feelings with a trusted person can be both useful and comforting.

Summary

A diagnosis of stage 4 lung cancer indicates that the cancer has spread to the other lung or more distant parts of the body. It is the final stage of lung cancer.

There is currently no cure, but certain treatments can prolong life. It may be that the side effects of these treatments will eventually outweigh the benefits, and a person may prefer to have palliative care. It is important to talk about every option in detail with the doctor before making a decision.

Having late-stage cancer affects a person physically, mentally, and emotionally. Seeking support from friends, family members, healthcare providers, and cancer support groups can help.