Table of ContentsView AllTable of ContentsTypes and StagesSymptomsDiagnosisTreatmentPrognosisCoping and Support
Table of ContentsView All
View All
Table of Contents
Types and Stages
Symptoms
Diagnosis
Treatment
Prognosis
Coping and Support
Lung cancerstarts in your lungs, but there’s a strong possibility that it will spread (metastasize) beyond the lungs and surrounding lymph nodes to other parts of the body if it isn’t brought into remission early. Doctors may refer to metastatic lung cancer as advanced lung cancer. The condition is considered inoperable, but it may be helpful to know thattreatmentsthat can help halt further spread and potentially extend life are improving every day.
Types of Advanced Lung Cancer
Approximately 85% of all lung cancers arenon-small cell lung cancers. Small cell lung cancer accounts for the remaining percentage of cases.
Among advanced non-small cell lung cancers, there are additional subtypes that include:
Making up the remaining cases of advanced non-small cell lung cancer are rarer forms of cancer, and, in some cases, tumors that have characteristics of more than one of the common types (these are defined as “other”).
Stages
Advanced lung canceris a term usually applied to cancer that has reached stage 3B or 4. About 17.6% of non-small cell lung cancers are already at stage 3B when they are diagnosed, and 40% are at stage 4.Advanced lung cancer can also result from the growth of stage 1, 2, or 3A tumors.
What Do the Different Stages of Lung Cancer Mean?
Advanced Lung Cancer Symptoms
Common lung-related symptoms may include:
When tumors spread or grow larger, advanced lung cancer symptoms and signs may occur, such as:
Specific symptoms related to common areas of metastasis include:
Advanced lung cancer may be initially found on an X-ray orcomputed tomography (CT) scan, but further testing with alung biopsyis necessary to determine whether or not an abnormality really is cancer and, if so, what type.
Traditionally, a tissue sample, orbiopsy, would be surgically taken from the cancer site. But doctors are increasingly using aliquid biopsy testto identify DNA from the tumor circulating in your plasma.
Lung cancer continues to be the leading cause of cancer deaths. But over the past two decades, the introduction of new medications has helped raise the overall survival rate for advanced cancer—including stage 4.
There were more new treatments approved for advanced lung cancer in the period between 2011 and 2015 than during the four decades prior to 2011. Keep this progress in mind whenever you look at research on this subject, since it often includes statistics from less recent time periods. Most importantly, keep your focus on the fact that thingscontinueto improve.
There are two basic categories of treatment: Systemic therapy and local therapy.
Systemic therapies includechemotherapy,immunotherapy, andtargeted therapies. These are the preferred treatments for advanced lung cancer because they can work throughout your body to eradicate cancer cells that have spread beyond the original tumor site.
Local therapies may be used in some cases.
Targeted Therapies
Among the amazing developments in cancer treatment has been the ability to identify genetic mutations in cancer cells and use medications that act on these genes to make the cancer cells ineffective.
The first step in this therapy is to undergo genetic testing, which can pinpoint several chromosomal abnormalities and gene mutations in cancer cells that are “targetable.”
For instance, if you have anEGFR mutation, the cancer cells are carrying out cell division at an excessive rate. The drugs that target these cells, tyrosine kinase inhibitors, send signals to stop that cell growth.
Other mutations that medications now target includeALKandROS1 mutations. Additional therapies have been approved and more are regularly being made available.
Chemotherapy
Chemotherapy is a mainstay for advanced lung cancer, and it has extended people’s lives for decades. There are many drug combinations used, but most of these include a “platinum” drug such as Platinol (cisplatin).
These drugs work to kill the malignant cells, but the goal is not to cure cancer with chemotherapy—especially in advanced lung cancer cases. Instead, the primary aim of chemotherapy with stage 3B and 4 cancer is to offerpalliativecare that eases symptoms and improves the quality of life.
Immunotherapy
How Does Immunotherapy and Work on Cancer?
Clinical Trials
Clinical trialsare research studies that test new ways ofpreventing,screening, andtreatingdiseases. Not everyone is a good fit for every type of trial, and there are some issues to consider before enrolling.
Learninghow clinical trials workand weighing the risks and benefits is worthwhile when you keep in mind that every new drug now offered to cancer patients was only able to be approved after undergoing thorough clinical trials
The National Cancer Institute funds and oversees clinical trials that regularly investigate new treatments for advanced non-small cell lung cancer. You can use theironline databaseto search for trials seeking participants.
Local Therapies
Treatment of lung cancer with metastases was essentially the same for everyone in the past, but that’s changing somewhat.
Local therapies, includingradiation therapyand surgery, are more effective for early-stage cancers where the malignancy is still one area. But they may occasionally be used along with the systemic treatments in the treatment of advanced lung cancer.
Radiation
In cases where there are few lesions (or spots of spread) resulting frombrain metastases, radiation treatment viastereotactic body radiotherapy (SBRT)has resulted in improved survival.
Surgery
Systemic treatments are sometimes used to decrease the size of stage 3B or stage 4 lung cancer tumors so that these tumors can be surgically removed. While it will not rid the body of all cancer, this type of surgery can improve the quality of life and extend survival.
It’s important to keep in mind, though, that the stress of surgery on top of systemic treatments may be too much for some people in advanced stages of lung cancer to tolerate.
Another path doctors have explored is using non-cancer drugs to help lung cancer patients. For example, drugs known asbisphosphonatesthat were originally used to treat osteoporosis may improve survival rates for people with bone metastases.
When looking at the statistics regarding survival rates for stage 3B and 4 non-small cell lung cancer, it’s important to consider that these numbers have been improving and the hope is they will continue to improve.
The current five-year survival for advanced lung cancer is just under 7%. That said, there are long-term survivors of advanced lung cancer, and that number is growing.
What you’ll quickly learn after being diagnosed with advanced lung cancer is that lung cancer takes patience, persistence, and support.
The first thing to remember is that it’s important to learn how tobe your own advocatein your cancer care, which means researching your condition, asking questions, and fighting for the treatment you think is best.
You’ll need to rely on others at some point as well, so reach out to family and friends.
You can also get support through in-person and onlinelung cancer communitieswhere you can find people who understand what you’re facing and cansupport you on your journey.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zappa C, Mousa S.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037%2Ftlcr.2016.06.07Lemjabbar-alaoui H, Hassan OU, Yang YW, Buchanan P.Lung cancer: Biology and treatment options.Biochim Biophys Acta. 2015;1856(2):189-210. doi:10.1016/j.bbcan.2015.08.002American Cancer Society.Signs and symptoms of lung cancer. Updated October 1, 2019.Del ciello A, Franchi P, Contegiacomo A, Cicchetti G, Bonomo L, Larici AR.Missed lung cancer: when, where, and why?.Diagn Interv Radiol. 2017;23(2):118-126. doi:10.5152/dir.2016.16187Takano N, Ariyasu R, Koyama J, Sonoda T, Saiki M, Kawashima Y, Oguri T, Hisakane K, Uchibori K, Nishikawa K, Yanagitani N, Ohyanagi F, Horiike A, Gemma A, Nishio M.Improvement in the survival of patients with stage IV non-small-cell lung cancer: Experience in a single institutional 1995-2017.Lung Cancer. 2019;131:69-77. doi:10.1016/j.lungcan.2019.03.008Roeland E, Leblanc T.Palliative chemotherapy: oxymoron or misunderstanding?.BMC Palliat Care. 2016;15:33.doi:10.1186%2Fs12904-016-0109-4National Cancer Institute.Immunotherapy to treat cancer. Updated September 24, 2019.National Cancer Institute.Treatment clinical trials for non-small cell lung cancer.Nikitas J, Roach M, Robinson C, Bradley J, Huang J, Perkins S, Tsien C, Abrahama C.Treatment of oligometastatic lung cancer with brain metastases using stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).Clin Transl Radiat Oncol. 2020;21:32-35. doi:10.1016%2Fj.ctro.2019.12.001Liu J, Huang W, Zhou R,Jia S, Tang W, Luo Y, Zhang J.Bisphosphonates in the Treatment of Patients With Metastatic Breast, Lung, and Prostate Cancer: A Meta-Analysis.Medicine (Baltimore). 2015;94(46):e2014. doi:10.1097/md.0000000000002014Howlader N, Noone A, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds).SEER Cancer Statistics Review, 1975-2017. National Cancer Institute. April 2020.Additional ReadingNational Cancer Institute. Non-Small Cell Lung Cancer Treatment – Health Professional Version (PDQ).
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zappa C, Mousa S.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037%2Ftlcr.2016.06.07Lemjabbar-alaoui H, Hassan OU, Yang YW, Buchanan P.Lung cancer: Biology and treatment options.Biochim Biophys Acta. 2015;1856(2):189-210. doi:10.1016/j.bbcan.2015.08.002American Cancer Society.Signs and symptoms of lung cancer. Updated October 1, 2019.Del ciello A, Franchi P, Contegiacomo A, Cicchetti G, Bonomo L, Larici AR.Missed lung cancer: when, where, and why?.Diagn Interv Radiol. 2017;23(2):118-126. doi:10.5152/dir.2016.16187Takano N, Ariyasu R, Koyama J, Sonoda T, Saiki M, Kawashima Y, Oguri T, Hisakane K, Uchibori K, Nishikawa K, Yanagitani N, Ohyanagi F, Horiike A, Gemma A, Nishio M.Improvement in the survival of patients with stage IV non-small-cell lung cancer: Experience in a single institutional 1995-2017.Lung Cancer. 2019;131:69-77. doi:10.1016/j.lungcan.2019.03.008Roeland E, Leblanc T.Palliative chemotherapy: oxymoron or misunderstanding?.BMC Palliat Care. 2016;15:33.doi:10.1186%2Fs12904-016-0109-4National Cancer Institute.Immunotherapy to treat cancer. Updated September 24, 2019.National Cancer Institute.Treatment clinical trials for non-small cell lung cancer.Nikitas J, Roach M, Robinson C, Bradley J, Huang J, Perkins S, Tsien C, Abrahama C.Treatment of oligometastatic lung cancer with brain metastases using stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).Clin Transl Radiat Oncol. 2020;21:32-35. doi:10.1016%2Fj.ctro.2019.12.001Liu J, Huang W, Zhou R,Jia S, Tang W, Luo Y, Zhang J.Bisphosphonates in the Treatment of Patients With Metastatic Breast, Lung, and Prostate Cancer: A Meta-Analysis.Medicine (Baltimore). 2015;94(46):e2014. doi:10.1097/md.0000000000002014Howlader N, Noone A, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds).SEER Cancer Statistics Review, 1975-2017. National Cancer Institute. April 2020.Additional ReadingNational Cancer Institute. Non-Small Cell Lung Cancer Treatment – Health Professional Version (PDQ).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Zappa C, Mousa S.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037%2Ftlcr.2016.06.07Lemjabbar-alaoui H, Hassan OU, Yang YW, Buchanan P.Lung cancer: Biology and treatment options.Biochim Biophys Acta. 2015;1856(2):189-210. doi:10.1016/j.bbcan.2015.08.002American Cancer Society.Signs and symptoms of lung cancer. Updated October 1, 2019.Del ciello A, Franchi P, Contegiacomo A, Cicchetti G, Bonomo L, Larici AR.Missed lung cancer: when, where, and why?.Diagn Interv Radiol. 2017;23(2):118-126. doi:10.5152/dir.2016.16187Takano N, Ariyasu R, Koyama J, Sonoda T, Saiki M, Kawashima Y, Oguri T, Hisakane K, Uchibori K, Nishikawa K, Yanagitani N, Ohyanagi F, Horiike A, Gemma A, Nishio M.Improvement in the survival of patients with stage IV non-small-cell lung cancer: Experience in a single institutional 1995-2017.Lung Cancer. 2019;131:69-77. doi:10.1016/j.lungcan.2019.03.008Roeland E, Leblanc T.Palliative chemotherapy: oxymoron or misunderstanding?.BMC Palliat Care. 2016;15:33.doi:10.1186%2Fs12904-016-0109-4National Cancer Institute.Immunotherapy to treat cancer. Updated September 24, 2019.National Cancer Institute.Treatment clinical trials for non-small cell lung cancer.Nikitas J, Roach M, Robinson C, Bradley J, Huang J, Perkins S, Tsien C, Abrahama C.Treatment of oligometastatic lung cancer with brain metastases using stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).Clin Transl Radiat Oncol. 2020;21:32-35. doi:10.1016%2Fj.ctro.2019.12.001Liu J, Huang W, Zhou R,Jia S, Tang W, Luo Y, Zhang J.Bisphosphonates in the Treatment of Patients With Metastatic Breast, Lung, and Prostate Cancer: A Meta-Analysis.Medicine (Baltimore). 2015;94(46):e2014. doi:10.1097/md.0000000000002014Howlader N, Noone A, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds).SEER Cancer Statistics Review, 1975-2017. National Cancer Institute. April 2020.
Zappa C, Mousa S.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037%2Ftlcr.2016.06.07
Lemjabbar-alaoui H, Hassan OU, Yang YW, Buchanan P.Lung cancer: Biology and treatment options.Biochim Biophys Acta. 2015;1856(2):189-210. doi:10.1016/j.bbcan.2015.08.002
American Cancer Society.Signs and symptoms of lung cancer. Updated October 1, 2019.
Del ciello A, Franchi P, Contegiacomo A, Cicchetti G, Bonomo L, Larici AR.Missed lung cancer: when, where, and why?.Diagn Interv Radiol. 2017;23(2):118-126. doi:10.5152/dir.2016.16187
Takano N, Ariyasu R, Koyama J, Sonoda T, Saiki M, Kawashima Y, Oguri T, Hisakane K, Uchibori K, Nishikawa K, Yanagitani N, Ohyanagi F, Horiike A, Gemma A, Nishio M.Improvement in the survival of patients with stage IV non-small-cell lung cancer: Experience in a single institutional 1995-2017.Lung Cancer. 2019;131:69-77. doi:10.1016/j.lungcan.2019.03.008
Roeland E, Leblanc T.Palliative chemotherapy: oxymoron or misunderstanding?.BMC Palliat Care. 2016;15:33.doi:10.1186%2Fs12904-016-0109-4
National Cancer Institute.Immunotherapy to treat cancer. Updated September 24, 2019.
National Cancer Institute.Treatment clinical trials for non-small cell lung cancer.
Nikitas J, Roach M, Robinson C, Bradley J, Huang J, Perkins S, Tsien C, Abrahama C.Treatment of oligometastatic lung cancer with brain metastases using stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT).Clin Transl Radiat Oncol. 2020;21:32-35. doi:10.1016%2Fj.ctro.2019.12.001
Liu J, Huang W, Zhou R,Jia S, Tang W, Luo Y, Zhang J.Bisphosphonates in the Treatment of Patients With Metastatic Breast, Lung, and Prostate Cancer: A Meta-Analysis.Medicine (Baltimore). 2015;94(46):e2014. doi:10.1097/md.0000000000002014
Howlader N, Noone A, Krapcho M, Miller D, Brest A, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds).SEER Cancer Statistics Review, 1975-2017. National Cancer Institute. April 2020.
National Cancer Institute. Non-Small Cell Lung Cancer Treatment – Health Professional Version (PDQ).
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