Table of ContentsView AllTable of ContentsCharacteristics of Stage 4 Lung CancersStage 4 Survival StatisticsFactors Influencing Survival RatesSummary
Table of ContentsView All
View All
Table of Contents
Characteristics of Stage 4 Lung Cancers
Stage 4 Survival Statistics
Factors Influencing Survival Rates
Summary
Advanced lung cancer, which has spread (metastasized) from the primary tumor to distant organs, is associated with lower survival rates. That’s because lung cancer becomes more difficult to treat as it progresses. According to the American Cancer Society, those withstage 4 non-small cell lung cancer(NSCLC) have a five-year relative survival rate of 9%.
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.
In fact, many factors can influence survival times, some of which (like smoking) are modifiable. Newertargeted therapiesandimmunotherapiesare also helping people with stage 4 cancer live longer with fewer side effects and a better quality of life.
This article discusses stage 4 lung cancer life expectancy and what factors may influence the outcome of a diagnosis.
Verywell / Jessica Olah
Lung cancer is staged to classify the severity of the disease. The staging ofNSCLChelps doctors choose the most appropriate course of treatment based on the likely outcome orprognosis.
Thestage of lung canceris determined using the TNM classification system, which categorizes the severity of the disease based on three conditions:
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, the 2018-released TNM classification system broke down stage 4 NSCLC into two substages:
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.
What Are the Signs of End-stage Lung Cancer?During the final stages of lung cancer, it’s common to experience the following:Fluid build-up around the lungsConsistent coughShortness of breathCoughing up bloodPainSevere fatigueWeight lossWhen lung cancer spreads to other parts of the body, you may notice symptoms such as:Headaches, confusion, balance issues, memory problems, or seizuresJaundiceSwollen lymph nodes in the neckBone pain
What Are the Signs of End-stage Lung Cancer?
During the final stages of lung cancer, it’s common to experience the following:Fluid build-up around the lungsConsistent coughShortness of breathCoughing up bloodPainSevere fatigueWeight lossWhen lung cancer spreads to other parts of the body, you may notice symptoms such as:Headaches, confusion, balance issues, memory problems, or seizuresJaundiceSwollen lymph nodes in the neckBone pain
During the final stages of lung cancer, it’s common to experience the following:
When lung cancer spreads to other parts of the body, you may notice symptoms such as:
Common Sites of Lung Cancer Metastases
Stage 4 lung cancer life expectancy is typically gauged using five-year survival rates. These estimate the percentage of people who will live forat leastfive years following the initial diagnosis.
Epidemiologists classify five-year survival rates in one of two ways.
The first approach is based on the TNM stage. Statistical survival times are matched to the stage of the disease.
By contrast, the one-year survival rate for stage 4 lung cancer was reported in one study to be between 15% and 19%. This means this portion of patients with metastatic disease lived forat leasta year.
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 returns a much lower five-year survival estimate (5.8%).It also fails to reflect the wide variability in stage 4 survival rates, particularly in people with limited metastases.
How Long Can You Live Without Treatment if You Have Stage 4 Lung Cancer?Research shows that persons who don’t receive treatment for NSCLC live on average for seven months.However, the survival time may be less for those with stage 4 cancer.
How Long Can You Live Without Treatment if You Have Stage 4 Lung Cancer?
Research shows that persons who don’t receive treatment for NSCLC live on average for seven months.However, the survival time may be less for those with stage 4 cancer.
How Fast Does Lung Cancer Spread?
There are seven factors known to influence survival times in people with stage 4 NSCLC.
Age
Older age is linked to poorer outcomes in people with lung cancer irrespective of their lung cancer stage. This is due to the fact that people over 70 are often in poorer general health and haveimmune systemsthat are less able to suppress tumor growth.
Older age not only influences the progression of the disease but survival rates as well. If you are under age 50 at the time of your diagnosis, you are more likely to live for at least five years compared to someone 65 and older.
Based on SEER data, the five-year survival rate for people with stage 4 lung cancer is 14.2% for those under 50. This drops to 5.6% for those 65 and over.
How Lung Cancer Is Treated in Older Adults
Sex
Male sex is independently associated with poorer outcomes in people with lung cancer in general. Men are not only more likely to get lung cancer than women but are more likely to die as a result of the disease.These factors contribute to the disparity in the overall five-year survival rate inwomenandmen.
Concerning stage 4 NSCLC, the five-year survival rates are 5.6% and 8.6% for men and women, respectively. Research suggests that men are at a genetic disadvantage. Compared to women, men are less likely to have"treatable" gene mutations—those that are responsive to newer targeted therapies used for stage 4 disease.
Interestingly, men prescribed drugs like Keytruda (pembrolizumab) tend to have lower survival overall but higher overall progression-free survival (i.e., the length of time in which the condition does not worsen) than women.
How Lung Cancer Differs in Women and Men
Performance Status
People with stage 4 NSCLC tend to be symptomatic. This doesn’t mean, however, that all people will be equally ill or disabled. There can be significant variations in the ability to function in everyday life, which doctors refer to asperformance status (PS).
There are several ways that PS is measured. The most common is called the Eastern Cooperative Oncology Group (ECOG) PS Score, which rates PS on a scale of 0 to 5. Under the ECOG system, a score of 0 means that you are fully functional, while a score of 5 indicates death.
Research suggests that around half of all people diagnosed with stage 4 lung cancer will have “good” PS, defined as an ECOG score of 0 to 2. Almost without exception, people with a PS in this range will survive longer than those with a PS of 3 or 4.
Using the ECOG PS Score, lung cancer survival rates and times (for all stages) break down as follows.
Among people with stage 4 lung cancer, an ECOG score of 0 translates to no less than an 11-fold increase in six-month survival rates compared to an ECOG score of 4, according to a 2015 study published inPLoS One.
Smoking Status
With that said, the consequences of smoking cessation—namely, nicotine withdrawal—may outweigh the benefits in heavy smokers with poor performance status and advanced stage 4 disease.
The decision to quit is ultimately a personal one, but something that should always be discussed prior to the start of cancer treatment.
Location and Type of Lung Cancer
There are many different types and subtypes of NSCLC, some of which are more aggressive than others. The three most common types are:
Research shows that the differences between these types influence survival rates.Moreover, the location of the tumor—whether in the airways (as withbronchioloalveolar adenocarcinoma) or in lung tissues themselves—can also have an impact on survivability.
While research on each NSCLC type in stage 4 is limited, survival rates are generally lower than the reported overall five-year survival rates, consistent with previous data reported.
Comorbidity
Roughly three of every four people with advanced lung cancer have another chronic health condition, referred to as a comorbidity. Having one or more comorbidities not only complicates lung cancer treatment but significantly impacts life expectancy.
Overall, some of the most common comorbidities in people with lung cancer includechronic obstructive pulmonary disease,diabetes, andcongestive heart failure.
Among people with stage 4 lung cancer specifically, there are two comorbidities that most directly influence survival times.
Genetic Mutations
The treatment of stage 4 NSCLC has evolved dramatically in recent years with the introduction of targeted therapies approved specifically for the treatment of metastatic lung cancer.
Unlike traditional chemotherapy drugs, these medications don’t attack all fast-replicating cells. Instead, they recognize and attack cancer cells with specific “treatable” mutations. Because of this, there is less collateral damage to normal cells and fewer side effects.
Not everyone has these genetic mutations, but, if they do, the drugs can significantly improve survival times. The three most common mutations are:
The effect of these drugs on survival times has been impressive. A 2019 study published in theJournal of Thoracic Oncologyfollowed 110 people with stage 4 NSCLC from 2009 to 2017, each of whom was treated with Xalkori in first-line therapy along with chemotherapy drugs.
Is It Possible to Beat Stage 4 Lung Cancer?There is no cure for Stage 4 NSCLC, but newer treatments are helping some people with this condition live longer than what was previously expected just a few years ago. Studies show that a small percentage of persons with this type of cancer are living (with the disease) for 10 years and longer.
Is It Possible to Beat Stage 4 Lung Cancer?
There is no cure for Stage 4 NSCLC, but newer treatments are helping some people with this condition live longer than what was previously expected just a few years ago. Studies show that a small percentage of persons with this type of cancer are living (with the disease) for 10 years and longer.
The Role of Genetic Testing With Lung Cancer
Stage 4 NSCLC is an advanced form of lung cancer in which cancer has spread from the lungs to distant organs or areas of the body. Research shows that those with this type of cancer face a five-year relative survival rate of 9%.
Factors such as age, sex, smoking status, and type of cancer may influence survival rates, according to research. While stage 4 lung cancer remains a serious diagnosis, it is important to remember that outcomes are not the same as 20 years ago. Survival rates are ever-increasing, and newer medications can now personalize treatment in ways that were once unheard of.
If you have any doubts about treatment recommendations, do not hesitate to seek asecond opinion, ideally from a specialist in one of the 71National Cancer Institute-designated treatment centersin the United States. Their practitioners are more likely to be on top of the current research and treatment strategies.
Top 10 Cancer Hospitals in the US
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