Lung cancer is classified into stages 0 through IV. Early-stage cancers (0, I, and II) are localized to the lungs or nearby areas. Stage III has likely spread to the lymph nodes, and Stage IV lung cancer has spread to other parts of the body. Stage IV lung cancer is also called distant or metastatic lung cancer.
While the five-year survival rates are lower for advanced lung cancer compared to earlier stages, effective treatment is still possible for many patients. Thanks to new therapies that have greatly improved outcomes, along with healthier lifestyle choices, patients diagnosed with Stage IV lung cancer can now live longer and enjoy a better quality of life than ever before.
Understanding Stage IV Lung Cancer and How It Is Different From Early-Stage Lung Cancer
Stage IV (4) lung cancer means the disease has spread (metastasized) from its original location in the lungs to at least one distant organ or another area of the body. Common places it can spread include the liver, bones, brain, the lining of the heart, and the adrenal glands, which are located above the kidneys.
In advanced-stage lung cancer, symptoms are often more apparent and severe compared to earlier stages. Patients may experience symptoms, such as extreme fatigue, pain, difficulty breathing, coughing, bleeding, loss of appetite, and emotional changes like depression and anxiety. As the cancer progresses, additional symptoms may develop, including bone pain or fractures, headaches, seizures, vision changes, or jaundice.
Treatment plans for stage IV lung cancer are different from those used for earlier stages. The goal of treating earlier-stage lung cancers is complete remission. However, for most patients with stage IV lung cancer, the primary goal of treatment is to slow the cancer’s growth, manage symptoms and side effects, and improve the patient's quality of life. It’s unlikely the cancer will be eliminated entirely. This may involve different treatment options, including targeted therapies, palliative care, or clinical trials that provide access to emerging lung cancer treatments.
How Long Can Someone Live with Late-Stage Lung Cancer?
According to the American Cancer Society, the 5-year survival rate for stage IV non-small cell lung cancer (the more common type) is 12%. These statistics are based on patients who are newly diagnosed with stage 4 lung cancer and do not apply to cases where the cancer has returned after initial treatment. Actual results differ for each patient based on how they respond to treatment.
Several personal and medical factors can also affect the prognosis for patients with stage IV lung cancer, including:
- Overall health: Patients who are generally healthier are more likely to tolerate treatments. Additionally, chronic conditions can complicate treatment.
- Age: Patients aged 65 and older tend to have lower survival rates.
- Gender: Women typically survive longer than men after diagnosis.
- Self-care: Living independently and taking care of yourself are associated with longer survival.
- Smoking: Quitting smoking before chemotherapy can increase survival by up to six months.
- Race: People of color often experience poorer outcomes due to late diagnoses or a lack of access to care.
- Response to treatment: How your body responds to treatment affects the length of survival.
- Tumor characteristics and location: Some types of cancer are more aggressive than others and spread more quickly, while the cancer's location in the body can also affect survival.
- Genetics: Cancers with genetic mutations can be treated with targeted drug therapies, which can increase survival time.
Additionally, some of the most powerful influences on survival times and overall quality of life include emotional strength, a positive outlook on survival, and a strong support system.
How is Stage 4 Lung Cancer Treated?
Although no one can provide exact answers regarding life expectancy, stage 4 lung cancer patients are experiencing longer survival times thanks to the availability of new targeted therapies.
Stage 4 lung cancer can be treated in several ways. The most common options include radiation, chemotherapy, targeted therapy, and immunotherapy. In some cases, surgery may be performed to remove a large tumor that is localized in the lung and causing pain or blocking breathing.
Your oncologist will create a lung cancer treatment plan tailored to your specific needs. Factors including how far the cancer has spread, whether your tumor has specific genetic mutations or proteins, and your age, overall health, and personal preferences will be considered. Regardless of where the cancer has spread to, it will still be treated with lung cancer treatments.
- Chemotherapy and/or radiation may be used either before surgery to shrink a large tumor or after surgery to destroy any remaining cancer cells in a localized area. These treatments can also be used to relieve pain or other symptoms caused by the tumor(s).
- Immunotherapy helps your immune system recognize and attack cancer cells. It is often most effective when the tumor expresses higher levels of PD-L1.
- Targeted therapy works by focusing on specific gene mutations found in lung cancer cells. Before starting treatment, doctors can perform biomarker testing on the tumor to identify mutations that may be more effectively treated with targeted therapy. These mutations are not inherited, but rather acquired over a person’s lifetime due to harmful environmental factors.
Some patients decide not to have active treatment. They may have other health conditions, or they believe the side effects of treatment outweigh the potential benefits. In these situations, your care team will focus on relieving symptoms, improving your comfort, and providing emotional support.
Related reading: 7 Questions to Ask Your Oncologist About Lung Cancer Treatment
Other Helpful Treatments for Stage 4 Lung Cancer Patients
Palliative care and symptom management are important parts of treatment for patients with Stage 4 lung cancer. A 2010 study from the Cancer Survivors Network showed that patients who started palliative care when diagnosed lived three months longer than those who continued treatment with chemotherapy and radiation alone. These patients also reported an improved quality of life.
Advances in Technologies and Therapies For Stage 4 Lung Cancers
As lung cancer research continues to advance, new technologies and treatment approaches offer additional treatment options for people with Stage IV lung cancer.
One focus of cancer research is immunotherapy. Clinical trials are currently exploring new immune-based treatments, both alone and in combination with chemotherapy. New immunotherapy drugs have been approved for advanced lung cancers. Research is also being done to identify which patients could benefit from these therapies.
Targeted therapies also offer innovative drugs for all types of lung cancer, designed to target specific genetic changes found in tumors. By understanding the unique genetic makeup of a tumor through biomarker testing, lung cancer doctors can offer more precise treatments tailored to the patient's cancer.
When standard therapies are no longer effective, many patients with Stage 4 lung cancer join clinical trials. These research studies test new medications or treatment combinations that are not yet widely available. If you are considering joining a lung cancer clinical trial, it is important to discuss questions or concerns you have with your lung cancer doctor so you can make an informed decision.
Research is also improving the ways lung cancer is diagnosed and treated. More accurate diagnostic tools and robot-assisted surgery allow oncologists to treat lung cancer more precisely, resulting in improved patient outcomes.
Participating in clinical research not only provides patients with access to potential new treatments but also contributes to discoveries that may lead to safer and more effective therapies for future patients.
View a complete list of all of the lung cancer research trials available through Compass Oncology.
The Latest Lung Cancer Treatments & Clinical Trials in Portland-Vancouver
Compass Oncology has lung cancer specialists who are up-to-date with the latest treatments for patients, including those diagnosed with advanced, stage IV lung cancer. If you are in the Portland, OR, or Vancouver, WA area, we offer comprehensive cancer care, including personalized treatment plans, second opinions, clinical trials, and supportive cancer care for lung cancer patients.
If you or a loved one was recently diagnosed with lung cancer, request an appointment at a Compass Oncology cancer center.
