Stage 4 lung cancer

If you have stage 4 lung cancer, it means your cancer has spread to other parts of your body. It is often called advanced lung cancer, or late-stage disease.

There are two categories of stage 4 lung cancer. These are stage 4a and stage 4b.

Stage 4a lung cancer means one or more of the following may have occurred:

The cancer can be any size
The tumour may have grown into nearby structures or spread to the lymph nodes
The tumour may have spread to the other lung
The cancer may be in the pleura or the heart or there are cancer cells in the fluid between the layers that cover the lung or the heart. This is called pleural effusion or pericardial effusion.
The cancer has spread to a single organ such as the brain, bones, liver or lymph nodes outside of the chest.

Stage 4b lung cancer means one or more of the following may have occurred:

The cancer can be any size
The tumour may have grown into nearby structures or spread to the lymph nodes
The cancer has spread to multiple organs and/or the lymph nodes outside of the chest.

Treatment for stage 4 lung cancer

Whilst stage 4 lung cancer is not curable, it is treatable, and many people can live well with advanced cancer.

Your treatment will depend on several factors including:

The type of lung cancer you have
The position and size of your tumour
Your general health and fitness.

Treatment for stage 4 lung cancer can include:

If you have a genetically mutation lung cancer, you may be able to have a targeted treatment. Everyone with lung cancer should have their cancer biopsied and tested for mutations to ensure opportunity for treatments are not missed.

Find out more about genomic testing in lung cancer.

Jules’s story

Jules is living with stage 4 lung cancer which has spread to her spine and pelvis. Her genomic tests revealed she had the EGFR+ mutation. This meant she could have a targeted cancer drug to treat her cancer.

Heather’s story

Heather is living with stage 4 lung cancer, mediastinal lymphadenopathy (which is where the lymph nodes in her chest swell) and bone metastases to her spine and right femur. She has received radiotherapy, chemotherapy and immunotherapy to treat her cancer.

Ongoing treatment for stage 4 lung cancer

The length of time you are on treatment will depend on several things.

If you have chemotherapy and radiotherapy, you tend to have a certain number of sessions. After your treatment finishes, you will have a scan to see how your cancer has responded to the treatment.

Your cancer doctor will then speak to you about the results and whether or not you would benefit from further treatment. If your cancer has responded well to the treatment, you may not need more treatment straight away.

If you are on a targeted therapy, you are likely to continue with the targeted drug you are on for as long as your cancer continues to respond, and your side effects are manageable.

If you have immunotherapy, there is likely to be a maximum number of sessions. This tends to be around 24 months, as long as your cancer continues to respond, and you do not have any adverse side effects.

Whatever treatment you are receiving, you will have regular checks up. This will include blood tests, scans and x-rays. If they show the cancer has grown or come back, your doctors will talk to you and explore other treatment options or supportive care.

About Lung Cancer