Stage 4 is an advanced stage of lung cancer, where the tumor has spread to nearby organs as well as distant organs and tissues. About 40% of people diagnosed with lung cancer are diagnosed at the 4th stage of cancer. The outlook of last-stage lung cancer is poor and there is no cure for this type of cancer. However, certain treatments are available which aim to prolong the survival period and relieve the signs and symptoms of lung cancer.
Signs to Expect in Stage 4 Lung Cancer
Common signs and symptoms of last-stage lung cancer include:
- A persistent cough
- Presence of blood in the mucus
- Hemoptysis, coughing up blood
- Chest pain
- Pain in the arms, shoulders, and back
- Difficulties breathing
- Hoarseness
- Repeated episodes of bronchitis or pneumonia
- Wheezing, etc.
If the tumor spreads to other parts of the body, the following symptoms may appear:
- If the tumor spreads to the bones, pain in the ribs, back, hips will appear.
- If the tumor spreads to the esophagus, difficulties swallowing will occur.
- If the tumor spreads to the brain, headaches, weakness, vision changes and even seizures will be seen.
- If the tumor spreads to the liver, jaundice, a yellowing of the skin and eye whites will appear.
Loss of appetite, unintended weight loss, and fatigue are common general signs and symptoms of metastatic lung cancer.
How Is Stage 4 Lung Cancer Treated?
This type of cancer has no cure, but various treatment options aim to prolong the survival period, as well as, to relieve its signs and symptoms as much as possible. Treatment is uniquely determined for every patient based on many factors such as the size of the primary lung cancer, organs and tissues where the lung cancer has spread, age, overall health, etc.
Chemotherapy
Chemotherapy is the primary treatment for last-stage lung cancer which can be given alone or in combination with radiation therapy. Commonly used drugs and combinations for the treatment of lung cancer at this stage include:
- Cisplatin and Etoposide
- Cisplatin and Vinorelbine
- Cisplatin and Gemcitabine
- Cisplatin and Docetaxel
- Cisplatin and Pemetrexed. This last combination of chemotherapy drugs is not used for the treatment of squamous cell carcinoma of the lungs.
If Cisplatin is contraindicated for whatever reason, then a combination of the above-mentioned drugs with Carboplatin is made. Chemotherapy medications can be given alone if a patient with stage 4 lung cancer can’t have combined chemotherapy for other medical problems or poor overall health. Single chemotherapy medications commonly used include:
- Gemcitabine
- Docetaxel
- Pemetrexed
- Vinorelbine
Targeted Chemotherapy
In cases when the lung tumor has not responded well to the above-mentioned chemotherapy drugs, a targeted chemotherapy might be recommended. The types of targeted chemotherapy are:
- Afatinib
- Gefitinib
- Crizotinib
- Erlotinib
Pemetrexed might be administered as maintenance chemotherapy in patients who have responded to chemotherapy.
Radiation Therapy
Radiation therapy is recommended to last-stage lung cancer patients together with chemotherapy or alone if chemotherapy is not an option. There are two types of radiation therapy available for the treatment of lung cancer, brachytherapy and external beam radiation therapy.
Endobronchial Therapy
Endobronchial therapies are often used in last-stage lung cancer patients in order to relieve the signs and symptoms caused by a blockage of the airways from the tumor. Available types of endobronchial therapies are:
- Laser surgery
- Brachytherapy
- Bronchial debridement
- Stent placement
- Electrocoagulation
- Photodynamic therapy
Surgery
Surgical treatment does not provide a cure for lung cancer, but instead, it is a palliative surgery in order to relieve the signs and symptoms of this type of cancer. Palliative surgical treatments available include:
- Pleurodesis
- Thoracentesis
- Chest tube placement
Clinical Trials
If all the above-mentioned treatments have not provided any relief of the last-stage lung cancer, then there is always the possibility to participate in clinical trials. Through clinical trials, patients can try new medical treatments which may even be successful. Consult your healthcare provider as he/she will tell you if you are a good candidate for such clinical trial.
What Is the Stage 4 Lung Cancer Life Expectancy?
The life expectancy of patients with last-stage lung cancer is short, only around eight months. The 5-years survival rate is only 4%, meaning that only 4% of all patients diagnosed with last-stage lung cancer has survived for more than 5 years. These numbers are sadly low, but worldwide, there are many patients who have lived for more than 5 years even though they have been diagnosed with last-stage lung cancer. Remember that you are not a number and there is always hope.
Keep in mind that the life expectancy of last-stage lung cancer varies from one person to the other due to various factors. Some of these factors include:
- Age – the younger you are, the greater is the possibility for a better life expectancy, compared to older people.
- Sex – women have a higher life expectancy than men, regardless in which stage lung cancer has been diagnosed.
- General health at the time of diagnosis – you will have a greater ability to withstand cancer treatments, extending this way the survival period if you have been healthy at the time of diagnosis.
- Type of cancer and its location – there are different types of lung cancer, but the location and the widespread of the cancer are also important for the survival rate. The genetic characteristics of the tumor are very important as well.
- Responding to the treatment – how you will respond to various treatments available for lung cancer varies and it is different from one person to the other. If you respond well to a certain treatment, you will be able to tolerate it better, prolonging this way the survival period.
- Lung cancer complications – such as blood clots can shorten the survival period significantly.
- Other health problems – often patients tend to have other health problems besides being diagnosed with stage 4 lung cancer, which will shorten the survival period significantly.