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    Stage 4 Lung Cancer Prognosis: What to Expect

    Have you or a loved one been diagnosed with stage 4 lung cancer? Learn what to expect, so you can get the best possible treatment and comfort.

    What to Expect with Stage 4 Lung Cancer

    Medically reviewed by Fred Aleskerov, MD — Written by Scott Frothingham and Laura Goldman — Updated on November 18, 2021

    Stage 4 lung cancer is the most advanced stage of lung cancer. In stage 4, the cancer has spread, or metastasized, to both lungs, the area around the lungs, or distant organs.

    What can I expect with stage 4 lung cancer?

    If you or a loved one has received a stage 4 lung cancer diagnosis, you’ll want to know what to expect so you can get the best possible treatment.

    Expect a rush of emotions

    Along with communicating with family and friends, consider joining a support group or seeking out a therapist or counselor.

    Expect to take charge of your healthcare decisions

    Many people are motivated to research available information from trusted resources. Then, they might discuss their findings with their healthcare team.

    One area to research could be available clinical trials. These might give you access to new treatments that could improve your outlook.

    Expect to make lifestyle changes

    Many people support their treatment by stopping behaviors that are harmful to their health, like smoking. You might also adopt healthy habits, such as staying physically active and incorporating healthy food choices into your diet as much as possible.

    Expect some relationships to change

    You might find that people start treating you differently than you hoped or predicted. Or you might find yourself needing something different from certain relationships.

    Be honest about your needs and seek the support of friends and family you trust.

    Expect palliative care

    Many lung cancer treatments have uncomfortable or concerning side effects. Sometimes treatment can be adjusted.

    Typically, your healthcare team can recommend a palliative care specialist. This is someone who focuses on the management of side effects.

    Expect checkups

    Even when you’re done with initial treatment, there’ll be follow-up visits, including testing to monitor your recovery.

    The most common type of lung cancer is non-small cell lung cancer. According to the American Cancer Society (ACS)

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    , about 13 percent of lung cancers are small cell lung cancers. Small cell lung cancers are more aggressive and may spread quickly.

    Stage 4 lung cancer is divided into two substages:

    Stage 4a is where the cancer has spread within the lungs or to one area outside the lungs.Stage 4b is where the cancer has spread to several places in one or more organs that aren’t close to the lungs, such as the brain, liver, or bones.

    According to the National Cancer Institute (NCI)

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    , 56 percent of lung and bronchus cancer cases are diagnosed at stage 4.

    Lung and bronchus cancer is the third most commonly diagnosed cancer, behind breast cancer and prostate cancer.

    It represents about 12.4 percent of all new cancer cases, the NCI reports, with an estimate of about 235,760 new cases in the United States in 2021.

    Factors that affect the outlook of the disease

    If you’ve received a diagnosis of stage 4 lung cancer, many factors will affect your outlook, including:

    Overall health. Commonly, if you’re healthy when you receive your diagnosis, it’s an indication that you might have a better ability to tolerate life-extending treatments.Age. Although data regarding the outcomes of older people with lung cancer is limited, a small 2013 study

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    found older age was associated with poorer lung cancer survival.

    Gender. According to the ACS

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    , the chances of a woman developing lung cancer sometime in her life are about 1 in 17, while for a man the risk is about 1 in 15.

    Race. The ACS also indicates that while Black women are 14 percent less likely to develop lung cancer than white women, Black men are about 15 percent more likely to develop lung cancer than white men. This may be the result of systemic environmental and healthcare-related factors.Response to treatment. If your body responds well to cancer treatment, you’ll likely have a higher chance of survival.Genetic mutations. According to 2015 research

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    , an epidermal growth factor receptor (EGFR) gene mutation is more common in women and nonsmokers with lung cancer. Targeted drug therapies can treat EGFR and other gene mutations, increasing survival rates.

    Lung cancer type and tumor location. Some subtypes of lung cancer, such as large cell lung carcinoma, are more aggressive than others. A tumor located in the alveoli instead of the lung cells, called a bronchioloalveolar adenocarcinoma, may result in a better survival chance, according to a 2011 study

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    Smoking. A 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 activities. Based on the Eastern Cooperative Oncology Group (ECOG) Performance Status

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    Source : www.healthline.com

    What Is the Life Expectancy for Stage Four Lung Cancer?

    Stage 4 lung cancer usually has a poor prognosis. Life expectancy for lung cancer is given as five-year survival rates, or how many people will be alive five years after diagnosis. Five-year survival rates for metastatic non-small cell lung cancer are 6%, while five-year survival rates for metastatic small cell lung cancer are 3%.

    CANCER CENTERTOPIC GUIDE

    How Long Does a Person Have to Live with Stage 4 Lung Cancer?

    Medical Editor: John P. Cunha, DO, FACOEP

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    Stage 4 lung cancer usually has a poor prognosis. Life expectancy for lung cancer is given as five-year survival rates, or how many people will be alive five years after diagnosis. Five-year survival rates for metastatic non-small cell lung cancer are 6%, while five-year survival rates for metastatic small cell lung cancer are 3%.

    Stage 4 lung cancer (also called metastatic lung cancer) is lung cancer that has spread (metastasized) to other parts of the body outside the lungs, such as the brain, bones, and liver.

    Life expectancy for lung cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. Stage 4 lung cancer usually has a poor prognosis.

    Five-year survival rates for metastatic non-small cell lung cancer are 6%

    Five-year survival rates for metastatic small cell lung cancer are 3%

    One study found that depending on the stage of the metastases (spread) the average survival time following diagnosis of stage 4 lung cancer ranged from 6.3 months to 11.4 months.

    There are a number of factors that can impact life expectancy with stage 4 lung cancer. Factors associated with a less favorable outcome include:

    Smoking

    Some studies have shown that some smokers with metastatic lung cancer who quit prior to starting chemotherapy increased life expectancy by as much as 6 months

    Older age

    How aggressive the cancer is

    Location of the cancer

    Being male

    Other underlying health conditions

    Congestive heart failure and cerebrovascular diseases (such as stroke,

    aneurysm, or vascular malformation) have a significant impact on survival time

    What Are Symptoms of Stage 4 Lung Cancer?

    Early in the disease, people with lung cancer may not have symptoms. When the symptoms occur, they may include:

    Persistent or worsening cough

    Coughing up blood or rust-colored sputum

    Chest pain that may be worse with deep breathing, coughing, or laughing

    Shortness of breath Breathing problems Wheezing Hoarseness Loss of appetite

    Unexplained weight loss

    Fatigue/tiredness Weakness

    Respiratory infections such as bronchitis and pneumonia that don’t go away or recur

    Symptoms of stage 4 lung cancer that has spread to other parts of the body may include:

    Swollen lymph nodes such as those in the neck or above the collarbone

    Nervous system effects from lung cancer that has metastasized to the brain

    Headache

    Weakness or numbness of extremities

    Dizziness

    Problems with balance

    Seizures

    Bone pain, such as in the back or hips

    Yellowing of the skin and eyes (jaundice) from cancer spread to the liver

    What Is the Treatment for Stage 4 Lung Cancer?

    Stage 4 lung cancers are widespread and very hard to treat and cure. Any of the treatments listed below may help patients live longer, but they are unlikely to cure the disease at this late stage.

    Treatment for lung cancer depends on the stage, and treatments for stage 4 lung cancer may include:

    Surgery

    Lobectomy or sleeve resection or removal of the entire lung (pneumonectomy)

    Photodynamic therapy (PDT)

    Laser therapy

    Adjuvant chemotherapy

    Radiation therapy

    Radiofrequency ablation (RFA)

    Lymph node removal Chemotherapy Immunotherapy

    Participation in clinical trials

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    Stage 4 Lung Cancer Life Expectancy

    Stage 4 lung cancer has no set course. Multiple factors can influence life expectancy. Learn more about what they are and review survival statistics.

    CANCER LIVING WITH

    Stage 4 Lung Cancer Life Expectancy

    Stage 4 Lung Cancer Life Expectancy 7 Factors That Can Influence Survival Times

    By Lynne Eldridge, MD Updated on February 23, 2022

    Medically reviewed by Doru Paul, MD

    Questions about life expectancy are often the first ones asked when someone is diagnosed with stage 4 non-small cell lung cancer (NSCLC), the most advanced stage of the disease in which cancer has spread (metastasized) from the primary tumor to distant organs. The median survival time for those with stage 4 lung cancer is around four months, which means that 50% of patients will still be alive four months after their diagnosis.1

    As distressing as this statistic may be, it is important to remember that stage 4 lung cancer has no set course. Many will live for months and even years longer than this.

    Multiple factors can influence survival times, some of which (like smoking) are modifiable. Newer targeted therapies and immunotherapies are also helping people with stage 4 cancer live longer with fewer side effects and a better quality of life.

    Verywell / Jessica Olah

    Characteristics of Stage 4 Lung Cancers

    Lung cancer is staged to classify the severity of the disease. The staging of NSCLC helps doctors choose the most appropriate course of treatment based on the likely outcome, referred to as the prognosis.

    The stage of lung cancer is determined using the TNM classification system, which categorizes the severity of the disease based on three conditions:

    The size and extent of the primary tumor (T)

    Whether nearby lymph nodes have cancer cells in them (N)

    Whether distant metastasis has occurred (M)2

    With stage 4 lung cancer, all three of these conditions will have occurred. With that said, the extent of metastasis can vary along with the prognosis.

    For this reason, stage 4 NSCLC was broken down into two substages with the release of the new TNM classification system in 2018:3

    Stage 4a lung cancer, in which cancer has spread within the chest to the opposite lung; or to the lining around the lungs or the heart; or to the fluid around the lungs or heart (malignant effusion)Stage 4b lung cancer, in which cancer has spread to one area outside of the chest, including a single non-regional lymph nodeStage 4c lung cancer, in which cancer has spread to one or multiple places in one or more distant organs, such as the brain, adrenal gland, bone, liver, or distant lymph nodes.

    Stage 4 lung cancer is incurable. Treatments, therefore, are focused on slowing the progression of the disease, minimizing symptoms, and maintaining an optimal quality of life.

    Common Sites of Lung Cancer Metastases

    Stage 4 Survival Statistics

    Stage 4 lung cancer life expectancy is typically gauged using five-year survival rates, which estimate the percentage of people who will live for at least five years following the initial diagnosis.

    Epidemiologists classify five-year survival rates in one of two ways.

    Survival Rates by TNM Stage

    The first approach is based on the TNM stage; statistical survival times are matched to the stage of the disease.4

    TNM Lung Cancer Stage Median Survival

    M1a 11.4 months M1b 11.4 months M1c 6.3 months

    By contrast, the one-year survival rate for stage 4 lung cancer was reported in one study to be between 15% and 19%, meaning this portion of patients with metastatic disease lived for at least a year.5

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    Illustration by Hetal Rathod, Verywell

    Survival Rates by Disease Extent

    A second method estimates survival rates based on the extent of cancer in the body. This is the approach used by the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. The SEER system classifies cancer in one of three broader categories:

    Localized: Cancer limited to the lungsRegional: Cancer that has spread to nearby lymph nodes or structuresDistant: Metastatic cancer6

    Under the SEER classification system, distant disease and stage 4 cancer are synonymous.

    The one drawback to the SEER approach is that stage 4a and 4b lung cancer are melded into one category. This generalized approach not only returns a much lower five-year survival estimate (5.8%) but fails to reflect the wide variability in stage 4 survival rates, particularly in people with limited metastases.

    SEER Stage at Diagnosis Percent (%) Surviving

    Localized 59% Regional 31.7% Distant 5.8% Unstaged 8.3%

    How Fast Does Lung Cancer Spread?

    Factors Influencing Survival Rates

    The variability in survival rates highlights one key reality about stage 4 lung cancer: no two people have the same disease. Arguably more than any other stage of the disease, stage 4 lung cancer survival is influenced by multiple factors, some of which are fixed (non-modifiable) and others of which can be changed (modifiable).

    There are seven factors known to influence survival times in people with stage 4 NSCLC.

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    Source : www.verywellhealth.com

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