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What To Expect With Stage 4 Lung Cancer
Stage 4 lung cancer is the most advanced type of lung cancer. Support groups, clinical trials, and a palliative care specialist can all help you navigate this advanced stage.
Lung cancer is the third most commonly diagnosed cancer in the United States. It represents 12.2% of all new cancer cases in the country.
In stage 4, the cancer has spread or metastasized to both lungs, the area around the lungs, or distant organs.
Read on to learn more about what to expect in stage 4 lung cancer.
Symptoms of stage 4 lung cancer may include:
Here are a few things to expect and ways to help you cope.
Rush of emotionsReceiving a diagnosis of stage 4 lung cancer can be difficult. It may cause a surge of emotions, such as:
To help you manage your emotions, you can speak with loved ones. You can also join a lung cancer support group, such as LUNGevity, or speak with a therapist.
Relationship changesYou might find that people start treating you differently or that you need something different from certain relationships. Be honest about your needs. Seek the support of friends and family you trust.
Lifestyle changesYou may have to stop certain lifestyle behaviors that are harmful to your health, such as smoking.
You might also find that you can no longer do things you once did. In some cases, this can make it difficult to manage your daily tasks, such as your finances and household chores.
Talk with family members and friends for support. You can also contact healthcare professionals for ways to manage lifestyle changes and address your quality of life concerns.
Regular checkupsAfter receiving a diagnosis of stage 4 lung cancer, you may have regular clinic visits with a healthcare professional, including an oncologist and other members of an oncology team. This is to monitor the cancer's spread.
Take these opportunities to tell your healthcare team how you're feeling. Ask for any support you may need, such as palliative care. Palliative care can severe as an extra layer of support for individuals with advanced cancer.
These clinic visits may be overwhelming. It could help to have someone come with you for support.
After your initial treatment, there will also be follow-up visits, including testing to monitor your recovery.
There are two types of lung cancer, which may have different outlooks and survival rates.
Non-small cell lung cancer (NSCLC)Non-small cell lung cancer (NSCLC) accounts for 80–85% of lung cancer diagnoses.
Healthcare professionals use a staging system from 0–4 to classify NSCLC, with 0 being the earliest and 4 being the most advanced. This helps determine the size of the tumor and where and how far it has grown.
Stage 4 lung cancer is divided into two substages:
Small cell lung cancer (SLCLC) accounts for 10–15% of lung cancer diagnoses. It's typically more aggressive and spreads more quickly than NSCLC.
Healthcare professionals use a two-stage system to classify SCLC:
Stage 4 SCLC is when it's extensive.
Survival rates for lung cancer are expressed using a 5-year relative survival rate. This rate compares the number of people living with a type and stage of cancer to the larger population. It showcases the likelihood of still being alive after the first diagnosis.
The American Cancer Society calculates the 5-year relative survival rate based on statistics from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program database.
SEER uses different stages to classify lung cancers:
Stage 4 cancer is when your cancer has spread to a distant part of your body.
Here are the 5-year relative survival rates based on people who received a diagnosis of NSCLC and SCLC between 2012 and 2018:
Survival rates are only estimates. Everyone's body responds to the disease and its treatments differently.
Several factors may affect your outlook after receiving a diagnosis of stage 4 lung cancer.
AgeA 2019 study found that older age was associated with poorer lung cancer survival.
SexA 2022 study found that females live longer than males after a lung cancer diagnosis.
Race and ethnicityAccording to a 2022 report from the American Lung Association, Black Americans, Latino Americans, Asian Americans, Pacific Islanders, and Indigenous Americans are more likely to die from lung cancer sooner than white Americans. This is largely due to racial disparities in healthcare coverage and access.
Genetic mutationsA 2015 study found that an epidermal growth factor receptor (EGFR) gene mutation is more common in females and nonsmokers with lung cancer. Targeted drug therapies that treat EGFR may increase survival rates.
Lung cancer subtypeA 2021 study found that people with adenocarcinoma lung cancer had a better 5-year relative survival rate than those with squamous cell carcinoma. People with SCLC had the lowest survival rate of all lung cancers.
Tumor locationA 2011 study found that a tumor in the alveoli instead of the lung cells, called a bronchioloalveolar adenocarcinoma, may result in a better survival chance.
SmokingA small 2018 study found that people with stage 4 lung cancer who quit smoking cigarettes before starting chemotherapy increased their survival time by as much as 6 months.
Ability to perform daily activitiesBased on the Eastern Cooperative Oncology Group (ECOG) Performance Status score, people with lung cancer who can do everyday functions may survive longer than people who cannot and need to stay in a bed or chair for more than 50% of the time.
Your overall health and response to treatment may also affect your outlook.
Treatment options during stage 4 lung cancer aim to reduce symptom severity and improve quality of life. Your treatment plan will depend on several factors, including:
Some treatment options include:
It's rare that these treatment options will cure stage 4 lung cancer. However, they may help manage cancer symptoms.
Learn more about taking care of yourself during stage 4 lung cancer treatment.
Palliative care, or supportive care, can be received alongside other lung cancer treatments to help improve your quality of life. The aim is to help ease your symptoms of cancer and medication side effects as well as provide emotional support.
Some possible palliative care services may include:
You can receive palliative care at home or in other places like a hospital, hospice, or care home.
Remember, it's never too early or late to ask for palliative care.
As a caregiver for someone living with stage 4 cancer, you can expect to see them experiencing many of the symptoms and changes listed above.
They may also experience spiritual changes, whether they're religious or not. The National Cancer Institute recommends that caregivers support and respect loved ones who depend on spirituality to help them cope with cancer.
The goal is to give person-centered, compassionate care that delivers improved quality of life and the best possible health outcomes.
However, caregiving is often emotionally and physically exhausting. This can lead to feeling overwhelmed and overburdened, a condition called caregiver burnout.
Learn more about preparation for NSCLC caregivers.
Below are frequently asked questions relating to stage 4 lung cancer.
How long can you live with stage 4 lung cancer?A person's outlook with stage 4 lung cancer can depend on the extent of the disease, their health, and several other factors. However, the estimated 5-year relative survival rate for stage 4 NSCLC is 9%. For stage 4 SCLC, it's 3%.
Can you survive stage 4 lung cancer?Stage 4 lung cancer is incurable. While treatments are advancing, it's still difficult to treat. Your outlook depends on several factors, such as the cancer's stage at diagnosis and treatment.
Does stage 4 cancer mean terminal?Stage 4 lung cancer is the most advanced. Although the 5-year relative survival rate is very low, it's not necessarily terminal. No treatments currently exist to cure stage 4 NSCLC. However, treatments may help reduce your symptoms and improve your quality of life.
Stage 4 lung cancer is the most advanced stage.
By understanding stage 4 lung cancer outlooks, you can anticipate what you'll experience as you navigate the treatment process.
With preparation, you can be prepared to make decisions that maximize your quality of life and wellbeing.
Coping With The Symptoms And Side Effects Of Advanced Lung Cancer
Advanced lung cancer can cause uncomfortable symptoms such as fatigue, coughing, and shortness of breath. Certain cancer treatments can also often have side effects.
Several strategies can help you cope with breathlessness, loss of appetite, fatigue, and more. You may also want to consider palliative care to manage both your symptoms and the emotional challenges of cancer.
Lung cancer may affect how you feel in various ways. Common symptoms of advanced lung cancer include:
Side effects of advanced lung cancer treatments vary depending on the person and the type of treatment. A few common side effects include:
Palliative care is also known as supportive care. This medical specialty helps you manage the symptoms and side effects of cancer. It also provides support for your loved ones.
A team of social workers will care for your physical and emotional well-being. They can help in the following ways:
Palliative care isn't hospice care, and it's not only for end of life. You can receive palliative care at any stage of your cancer journey. Many people continue to have cancer treatments while receiving palliative care.
Ask your primary doctor about how palliative care might help you.
Feeling fatigued all the time can be one of the most challenging parts of advanced lung cancer. Physical, emotional, and mental fatigue can keep you from daily activities.
The cancer itself or the treatments you receive can cause fatigue. Several strategies can help you cope:
Shortness of breath is a common lung cancer symptom. Treating common causes of shortness of breath and learning breathing techniques can help.
Common causesTreating the following causes for shortness of breath can help you breathe easier:
The diaphragm is the muscle that controls your breathing. Diaphragmatic breathing techniques strengthen this muscle, bringing more air into your lungs using less energy. Breathing this way can manage shortness of breath and may reduce stress and anxiety.
It may be helpful to practice breathing exercises when you aren't feeling short of breath. That way, you'll feel more confident using them when you need them most.
You can try following these steps:
During this process, your chest should remain as still as possible.
Loss of appetite is another common symptom of advanced cancer. Feeling sick can reduce your appetite.
Here are some ideas to help you eat when you're not feeling hungry:
The symptoms and treatments of advanced lung cancer can take a toll on your mental health. It's essential to care for your emotional well-being to help you cope.
You may find joining a support group is helpful. It's an opportunity to share experiences and wisdom with others going through the same experience.
Working with a mental health professional may also be beneficial. This person can help you identify, understand, and manage difficult thoughts and feelings.
It can be challenging to manage the symptoms of advanced lung cancer and the side effects of treatments. Prioritize your emotional and physical well-being.
Ask for help. Rest when you're tired. Save your energy for the things that matter most to you. Seek support from others. Find a palliative care team or a support group.
Caring for both your emotional and physical health can help you cope with symptoms and side effects.
The 12 Lung Cancer Symptoms Commonly Found In Patients Who Have Never Smoked
WE'RE all well aware of the perils of smoking, with cigarettes responsible for seven out of 10 cases of lung cancer.
If you've never puffed on a cigarette, your odds of sidestepping the disease are altogether much stronger.
1
Smoking cigarettes is one of the biggest drivers of lung cancer, but inhaling secondhand smoke can also put you at riskCredit: PABut it's still possible to develop lung cancer even if you've sworn off tobacco.
In fact, up to 14 per cent of people with lung cancer in the UK have never smoked, according to Cancer Research UK.
"To put this into perspective, if lung cancer in people who have never smoked was a separate disease, it would be the eighth most prevalent cause of cancer-related death," the charity warns.
In some ways, nonsmoker lung cancer might be considered a separate disease to smoking-related lung cancer, as it has unique molecular and biological characteristics and responds differently to treatment.
Sufferers might also be struck down by a different set of symptoms, according to oncologists at Yale Medicine.
Anne Chiang, a thoracic medical oncologist and chief network officer at Yale's Smilow Cancer Hospital, explained: "We used to think all lung cancers were the same, but now we understand that there are different kinds.
"The good news is that the types of lung cancer that nonsmokers tend to get are usually driven by a molecular change or mutation that can be detected in the tumour, and there are drugs and therapeutics available for them," she said.
Most nonsmokers are in fact diagnosed with a non-small cell type known as adenocarcinoma, which often starts in the outer areas of the lungs, in mucus-producing cells that line the small airways called bronchioles.
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I was a middle-aged porn addict… I'd sneak off to toilets to watch at workBy contrast, smokers tend to develop a type of non-small cell lung cancer squamous cell carcinoma, Yale oncologists said.
Thoracic surgeon says Daniel Boffa said adenocarcinoma has a different shape to other types of lung cancer.
"If you are a smoker, you can think of your lung as a bag of white marbles, and cancer is like putting a black marble in there," he explained.
Is vaping better than smoking?"The type of cancer a nonsmoker gets is more like putting in black sand. Instead of a spot or a lump, it's more like a hazy area. It's more diffuse."
If you haven't smoked, your lung cancer is also more likely to grow more slowly.
What are the symptoms of nonsmoker lung cancer?Most nonsmokers have no early signs of lung cancer, which means they're often not diagnosed until it has spread.
But some people do notice symptoms in the cancer's early stages, Yale oncologists said.
These are similar to the symptoms in smokers and may include the following:
Even if you've never picked up a cigarette in your life, a combination of other factors can still put you at risk of developing the disease.
For starters, passive smoking - breathing in other people's cigarette smoke - can slightly increase your risk, according to Macmillan Cancer Support.
Your age is another driver, as the cancer is more common in older people, with more than four in 10 people diagnosed with lung cancer being 75 and over.
Materials and substances you inhale while working can also increase your chances of developing lung cancer.
One such material is asbestos, a material that was previously used in the building industry.
People who have been in prolonged or close contact with asbestos have a higher risk of getting lung cancer, Macmillan said.
Heavy metals and diesel exhaust are two more cancer-causing agents that people could be exposed to at work, Yale oncologists added.
Then there's radon gas.
In certain parts of the UK, a natural gas called radon can pass from the soil into the foundations of buildings.
While exposure to high levels of radon isn't common, it can increase the risk of developing lung cancer, particularly in people who also smoke.
Finally, where you live can also up your risk, as research has shown that air pollution can be a driving factor behind lung cancer cases.
The risk is linked to air quality and how much pollution a person is exposed to, but for most people, the risk is very small, Macmillan noted.
It was announced last year that more than a million smokers and ex-smokers will be invited for NHS lung checks under an ambitious targeted lung cancer screening programme.
Those who will be called forward for checks include people who:
Nonsmokers risk of cancer might not be eligible for the screening programme, but you should speak to your GP if you have a family history of lung cancer.
It's also important to bring up concerns about exposure to secondhand smoke, radon, pollution or other known contributors.
You should see a GP if you experience any lung cancer symptoms.
How does smoking increase your risk of lung cancer?
SMOKING cigarettes is the single biggest risk factor for lung cancer.
It's responsible for more than seven out of 10 cases, according to the NHS.
Tobacco smoke contains more than 60 different toxic substances, which are known to be carcinogenic.
If you smoke more than 25 cigarettes a day, you are 25 times more likely to get lung cancer than someone who does not smoke.
Frequent exposure to other people's tobacco smoke - known as passive or secondhand smoking - can also increase your risk of developing lung cancer.
Aside from cigarettes, the following products can also put you at risk of the disease:
Source: NHS
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