Stage 4 Lung Cancer Life Expectancy Without Treatment

Cancer is undoubtedly one of the worst illnesses to endure and live with. However, lung cancer takes it to another level. Lung cancer is known to be the 2 leading cancer in the world with an estimated 1.8 million deaths in the year 2020.

Picture yourself waking up one morning and you came to the realization that you are afflicted with this fatal disease. It’s difficult to fathom the fear and to imagine how scary life will be. Regrettably, this is the harsh reality for many individuals in the world. 

Lung cancer is one of the lethal types of cancer that poses significant challenges in terms of treatment. Despite receiving top-notch medical care, the chances of survival from a patient with it remain at an alarmingly low rate. So if you or a loved one has been diagnosed with this condition, it is important to understand that the battle ahead will be exceedingly tough but it is crucial to keep fighting and never lose hope.  

In this blog, we will provide you with all the information you will need to know about stage 4 cancer and its survival rate. 

Stages of Lung Cancer

Lung cancer has four main stages which are determined by how far a cancer has spread throughout the body.

• Stage 1: It is confined to the lungs itself and has not spread to the other parts of the body.
• Stage 2: Still confined to the lungs but has spread to the nearby lymph nodes.
• Stage 3: The cancer has spread beyond the lungs and the lymph nodes and to the other parts of the body in areas like the bones or liver.
• Stage 4: Cancer in the most advanced stage. Cancer has spread to multiple parts of the body.

Characteristics of Stage 4 Lung Cancer

Staging of cancer is essential for determining the severity of the disease. Staging of NSCLC (Non-Small Cell Lung Cancer) can assist healthcare professionals in selecting the, most suitable treatment plan according to the prognosis. TNM (Tumour, Node, Metastasis) staging system is used to determine the stages of lung cancer based on three conditions. 

• Size and the scope of the initial tumor (T).
• Presence of cancer cells in the adjacent lymph nodes (N).
• Occurrence of distant metastasis(M).

With stage 4 lung cancer, it is characterized by the occurrence of all three conditions. It’s important to note that the extent of metastasis and the prognosis can vary. As a result, the 2018 released TNM classification system divided stage 4 NSCLC into 2 subtypes.

• Stage 4a lung cancer: It involves the spread of cancer within the chest area to the opposite lung, the lining around the lungs or heart, or the fluid around the lungs or heart (malignant effusion).
• Stage 4b lung cancer: It is characterized by the spread of cancer to one or multiple places in one or more distant organs, such as the brain, adrenal glands, bone, liver, or distant lymph nodes.

Note: A stage 4 lung cancer cannot be cured so, the primary objective of the treatments is to decelerate the advancement of the illness, alleviate symptoms, and uphold an optimal standard of living.

Signs of End-stage Lung Cancer

For an individual suffering from end-stage lung cancer, it is common to experience the following signs:

• Weight loss
• Severe fatigue
• Shortness of breath
• Consistent cough
• Build up fluid around the lungs
• Coughing up blood

When the cancer metastasizes to other areas of the body, you might observe signs such as:

• Headaches
• Confusion
• Balance issues
• Memory problem/loss
• Seizures
• Jaundice
• Swollen lymph nodes in the neck
• Bone pain

Stage 4 Lung Cancer Survival Rate

A person with stage 4 lung cancer’s life expectancy without treatment comes around 4 to 8 months. It can depend on the overall health of the individual, the extent of the spread, etc. However, for a person with Stage 4 lung cancer with treatment their life expectancy is commonly assessed through five-year survival rates, which indicate the proportion of individuals expected to survive for a minimum of five years after being diagnosed. It is important to comprehend that an individual advanced age is associated with a negative prognosis, mainly due to the higher likelihood of developing other health complications as they grow older. 

Survival Rates by TNM Stage

This approach is based on the TNM stage. Stage of the disease is taken into account when matching statistical survival times. In contrast, a study has reported that the one-year survival rate for stage 4 lung cancer ranges from 15% to 19%. It indicates that a percentage of individuals/patients with metastatic disease survived for a minimum of 1-year.

Survival Rates Based on The Disease Extent

This method estimates survival rates based on the extent of cancer in the body. It is an approach that is 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 that is confined to the lungs and has not spread to any other parts of the body.
• Regional: Cancer that has extended beyond the lungs and has reached the nearby lymph nodes or structures.
• Distant: Cancer that has spread to distant parts of the body from its original site in the lungs.

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Factors That Influence The Survival Rate

The diversity in survival rates underscores a fundamental truth regarding stage of stage 4 lung cancer. Every individual experience with the disease is unique. Survival rate for stage 4 lung cancer is significantly impacted by various factors, more so than any other stage of the disease. Some of these factors are unchangeable (non-modifiable), while others are modifiable. Seven factors have been identified as affecting survival durations in individuals with stage 4 NSCLC are: 

Age: Age can play an important role as the older a person is the poorer outcomes in people with lung cancer which is irrespective of their cancer stage. It’s due to the fact that people who are over the age of 70 are mostly in poorer health and have an immune system that are less able to suppress the growth of the tumor in the body.

Sex: Males are linked to a worse prognosis among individuals diagnosed with lung cancer overall. Men not only have a higher incidence of lung cancer compared to women, but they also have a higher mortality rate from the disease. These variables play a role in the difference observed in the five-year survival rate between women and men. The survival rate of women comes to around 27% while a man’s survival rate is about 19.2%.

Performance Status: Individuals who are diagnosed with stage 4 NSCLC often exhibit symptoms, but it is important to note that not everyone will experience the same level of illness or disability. Discrepancies in performance status, or the ability to carry out daily activities, can vary significantly among patients.

Smoking: Smoking is an important factor that has contributed to cancer in the lungs. It’s never too late to stop smoking as even among patients with stage 4 lung cancer are told to quit smoking before starting chemotherapy as it can increase the survival rate.

Type of Lung Cancer And Its Location: Research has shown that differences between the types will influence the survival rates. Also, the location of the tumor i.e. whether in the airways or in the tissues of the lungs can also impact on the survival rate. 

Multiple Chronic Conditions: Approximately around 75% of the individuals are diagnosed with advanced lung cancer and have at least one other chronic health condition, known as a comorbidity. The presence of comorbidities not only adds complexity to the treatment but also has a substantial effect on life expectancy.

Genetic Mutations: The management of stage 4 NSCLC has undergone significant advancements in the recent years due to the development of targeted therapies that are specifically approved for treating metastatic lung cancer. In contrast to conventional chemotherapy agents, these drugs do not indiscriminately target all rapidly dividing cells. Rather, they are designed to identify and combat cancer cells that possess particular “treatable” genetic mutations. As a result, there is reduced harm to healthy cells and a decrease in adverse effects.

Treatment For Stage 4 Lung Cancer

Treatment for stage 4 lung cancer will depend on the extent of how much the cancer has spread to the body, the presence of genetic mutations in the body, and the overall health of the patient. 

Treatments that are recommended for treating lung cancer are as follows:

• Surgery
• Chemotherapy
• Radiation therapy
• Targeted therapy
• Immunotherapy
• Photodynamic therapy

Helpful: Lung Cancer Treatment Cost In India

Take Away

Stage 4 lung cancer represents an aggressive stage of cancer where the disease has metastasized to distant organs or other parts of the body. Studies have indicated that individuals who are diagnosed with this particular cancer type have a relative survival rate of only 9% over five years. 

In case you are uncertain about the treatment suggestion by your treating doctor, feel free to consult with another healthcare professional for a second opinion.