Lung cancer has 4 stages, which are determined based on three main criteria:
1. Size and location of the tumor
The size of the tumor is critical for staging: for instance, a 2 cm tumor differs significantly from a 5 cm or 8 cm tumor. Additionally, a cancer located in the main airway differs in stage from one situated in a corner of the lung.
2. Whether it has spread to lymph nodes
The absence of lymph node involvement indicates an earlier stage (stage 1), while spread to lymph nodes signifies a more advanced stage (stage 2 or 3).
3. Whether it has metastasized to other organs
If not detected early, lung cancer can spread to the other lung, brain, bones, adrenal glands, liver, or other body parts. In this case, the cancer reaches its most advanced stage, stage 4.
Stage 4 Lung Cancer
In stage 4 lung cancer, the cancer has metastasized (spread) from the lung to other organs or tissues, such as bones, brain, adrenal glands, liver, or soft tissues. It is the most advanced stage of lung cancer.
Lung cancers are divided into two main groups: “Small Cell” Lung Cancer and “Non-Small Cell” Lung Cancer. The treatments for these two groups differ.
Below are the treatment methods for both groups.
Treatment for Non-Small Cell Lung Cancer in Stage 4
- At this stage, because the cancer has metastasized to other organs, surgery is generally not preferred except in certain cases.
- The most appropriate treatments include chemotherapy, targeted therapies, immunotherapy, and, if necessary, radiotherapy for metastatic sites.
- For cancers other than squamous (epidermoid) cell carcinoma, targeted therapies (smart drugs) improve treatment success.
- To determine eligibility for smart drugs, genetic tests (EGFR, ALK, and ROS-1) must be conducted on biopsy samples.
- Surgery may be beneficial in very specific cases (e.g., a single metastasis in the brain or adrenal gland that has been or can be treated).
Stage 4 Small Cell Lung Cancer
In this group, smart drugs or immunotherapy are not used. Treatment consists of two components:
- Chemotherapy – Drug Therapy
- Radiotherapy – Radiation Therapy
Recommendations for Stage 4 Lung Cancer
Using targeted therapies can improve treatment outcomes in this stage. However, only about a quarter of patients are eligible for these therapies.
Promising results have been achieved with immunotherapy—consult your oncology specialist.
Supportive treatments aim to maintain the patient’s quality of life.
Palliative care should be applied to manage symptoms such as shortness of breath, pain, or severe weight loss.
Be cautious of alternative treatments, which often provide no benefit and may mislead patients and their families.
Prognosis for Stage 4 Lung Cancer
One of the most frequently asked questions from patients and their families is about the chances of recovery with treatment. The statistics below reflect the results of international studies conducted on large numbers of patients.
One-year survival rate: (Cancer Research UK)
The one-year survival rate for stage 4 lung cancer is 14%.
Five-year survival rate: (American National Cancer Institute)
The five-year survival rate for stage 4 lung cancer is 1%.
NOTE: These statistics are from before the widespread use of targeted therapies and immunotherapy. With these advancements, survival rates for patients eligible for these treatments in stage 4 lung cancer are better than those shown here.
Below are answers to frequently asked questions we have received from patients and their families about stage 4 lung cancer. These questions and answers may provide useful information.
For treatment of stage 4 lung cancer, you should consult a medical oncology specialist.
