Living With Stage 4 Lung Cancer: Survival Rates, Treatments, Emotional Support, and More

Medically Reviewed
clinical trials, support groups, surrounded by family
Many resources and treatments are available for people living with stage 4 lung cancer.iStock (4)

Stage 4 lung cancer is the most advanced form of the disease. According to the American Cancer Society, stage 4 means the lung cancer has spread, or what doctors call “metastasized,” beyond the lung. Though cancer can travel anywhere in the body, lung cancer is most likely to metastasize to the brain, bones, liver, and adrenal glands, notes Moffitt Cancer Center in Florida.

According to the American Society of Clinical Oncology (ASCO), stage 4 lung cancer is divided into two subcategories:

  • Stage 4A The cancer has spread within the chest or it has spread to one area outside the chest, or both.
  • Stage 4B The cancer has spread outside the chest to more than one area in one organ or to more than one organ in the body.

About 40 percent of lung cancers are not diagnosed until they are stage 4, says the National Cancer Institute. Though there’s no cure for the majority of stage 4 lung cancers, more people with this disease are living longer than ever before, according to the American Lung Association.

A diagnosis of advanced lung cancer can be upsetting news for patients and their loved ones. But supportive resources are available to help you navigate this disease and live a full life. Newer treatment options along with palliative care approaches can help keep symptoms under control and improve the outlook for many people with stage 4 lung cancer.

Survival Rates for Stage 4 Lung Cancer

Survival rates for stage 4 lung cancer depend on the type of lung cancer, the extent of its spread, and the overall health of the individual. The American Cancer Society explains that there are two main types of lung cancer:

  • Non-small-cell lung cancer (NSCLC) This is the most common type, making up about 80 to 85 percent of cases. NSCLC typically has a better prognosis than SCLC.
  • Small-cell lung cancer (SCLC) This type tends to grow and spread more quickly. It accounts for about 10 to 15 percent of lung cancer cases. Instead of being categorized into numbered substages like NSCLC, small-cell lung cancer is often described as limited (present in one lung and may have spread to nearby lymph nodes) or extensive (spread throughout the original lung, the other lung, or other areas of the body).

According to data from the American Cancer Society, the five-year survival rates for people with stage 4 lung cancer that has spread to distant areas of the body is:

  • 9 percent for NSCLC
  • 3 percent for SCLC

While survival rates can give you an understanding of how many people with your same type of cancer are alive five years after a diagnosis, it’s important to know that they are only estimates. Many individuals with advanced lung cancer live longer than expected, according to ASCO.

Symptoms of Stage 4 Lung Cancer

Stage 4 lung cancer symptoms can vary depending on where the cancer has spread in the body. Additionally, many people with advanced disease experience both physical and emotional effects.

According to Moffitt Cancer Center, some symptoms of stage 4 lung cancer include:

  • Pain in the back or abdomen
  • Persistent or excessive coughing
  • Coughing up blood
  • Difficulty breathing
  • Weakness or fatigue
  • Breathlessness
  • Chest pain
  • Hoarseness
  • Poor appetite
  • Weight loss
  • Frequent infections
  • Swollen lymph nodes
  • Headaches, balance problems, or seizures (if the cancer has spread to the brain)
  • Jaundice (if the cancer has spread to the liver)
  • Bone pain (if the cancer has spread to the bones)

Treatments for Stage 4 Lung Cancer

Treatments for stage 4 lung cancer typically focus on lessening symptoms, prolonging survival, and improving quality of life. ASCO emphasizes that lung cancer is treatable at any stage of the disease.

Generally, therapies for stage 4 lung cancer aren’t intended to cure the cancer. But the American Cancer Society points out that, in rare cases, some stage 4A lung cancers that are limited to the lungs and only one other site (such as the brain) can be treated and even cured with surgery, radiation, chemotherapy, or a combination of these treatments.

Options for all other types of stage 4 lung cancers depend on the type of cancer, where it has spread, whether certain gene mutations feed the cancer, and a person’s overall health.

Sometimes, doctors will combine different treatments and other supportive modalities to improve a person’s quality of life. This approach, known as palliative care, focuses on relieving pain and making a person more comfortable. According to the NIH, palliative care can be given along with standard medical treatments and can be started at the time of diagnosis.

Targeted Treatments

If you have advanced lung cancer, your doctor will likely order special tests to see if your tumor contains certain gene mutations, according to the American Cancer Society. Targeted treatments slow the growth of tumors by focusing on these specific defects in lung cancer cells. Some of these treatments target mutations in the following genes:

  • KRAS
  • EGFR
  • ALK
  • BRAF
  • RET
  • ROS1
  • MET
  • NTRK


Immunotherapy uses the body’s own immune system to recognize and fight cancer cells. If a person’s lung tumor cells contain high levels of the protein PD-L1, they may be more likely to respond to immunotherapy treatments called checkpoint inhibitors, says the American Cancer Society.


Chemotherapy uses drugs to kill cancer cells in the body. According to the American Cancer Society, chemo can be used along with targeted treatments or immunotherapy for stage 4 lung cancers.


Doctors sometimes perform surgery to remove tumors if they cause pain. The Canadian Cancer Society notes that surgery may be done for stage 4 lung cancers that have spread to the brain, adrenal gland, or liver.

Additionally, doctors may perform procedures to drain fluid if it builds up in the space around the lungs or heart, according to the American Cancer Society.


Radiation therapy can be used to shrink tumors and help relieve symptoms of stage 4 lung cancer. It’s commonly used to treat lung cancers that have spread to the bones or brain and in patients who can’t have chemotherapy, explains the Canadian Cancer Society.

Photodynamic Therapy

Photodynamic therapy uses special photosensitizing drugs along with light to kill cancer cells. The Mayo Clinic says that this treatment can be used for lung cancers that grow into an airway and cause coughing, bleeding, or difficulty breathing.

Complementary and Integrative Approaches

Complementary therapies may be used along with standard treatments to help people with stage 4 lung cancer reduce side effects, lessen anxiety, and feel better.

Some of the modalities listed by the American Lung Association include:

  • Meditation Breathing and other techniques are used to quiet the mind.
  • Biofeedback Patients learn how to control some of their bodily functions, such as their heart rate.
  • Yoga Stretches, meditation, and controlled breathing exercises
  • Massage Therapists use different movements and techniques to manipulate muscles and other soft tissues in the body.
  • Chiropractic care Chiropractors make adjustments to the spine and joints to help ease pain.
  • Reflexology This is a special type of massage that involves applying pressure to specific points in the feet or hands.
  • Tai chi This is a form of exercise that uses slow body movements and controlled breathing methods.
  • Reiki With Reiki, guided energy is thought to promote a healing response. The practitioner places their hands on or just above a person’s body.

Clinical Trials

Participating in a clinical study may allow individuals with stage 4 lung cancer to receive cutting-edge treatments that aren’t otherwise available. Talk to your doctor if you’re interested in joining a clinical trial.

What Is Metastatic Lung Cancer, and Is It Stage 4?

The National Cancer Institute defines metastatic cancer as cancer that spreads from where it originated to a distant part of the body. Generally, when it comes to describing lung cancer, metastatic disease is synonymous with stage 4. According to the Moffitt Cancer Center, there’s also something called local metastasis. This means the cancer cells have invaded only surrounding tissues; in lung cancer, the cells typically spread to other parts of the lung.

According to the American Cancer Society, the prognosis for lung cancer that is localized (no sign of cancer outside the lung) is much better. The five-year survival rate for localized NSCLC is 65 percent, compared with 9 percent for distant NSCLC.

When cancer cells metastasize, they break off from where they first developed and form new tumors. Though the cancer has spread to a new area of the body, it’s still named after its original location, says the National Cancer Institute. For instance, lung cancer that metastasizes to a person’s brain is still called lung cancer.

How Can You Manage Emotional Health With Stage 4 Lung Cancer?

The news that you have stage 4 lung cancer can trigger a variety of emotions. You may feel overwhelmed, scared, or angry. You also might wonder how to share this information with your family and loved ones. While everyone copes differently, there are some effective ways to manage your emotions during this challenging time.

Resources for Emotional Support

According to the American Lung Association, the following resources may be helpful for someone dealing with a cancer diagnosis:

  • Join a support group
  • Journal about your feelings
  • Talk to family members or friends
  • Seek the guidance of a therapist or spiritual counselor

A small study published in the Asia-Pacific Journal of Oncology Nursing in August 2022 found that a specific type of mindfulness-based behavioral therapy called acceptance and commitment therapy (ACT) significantly improved depression, fatigue, anxiety, and quality of life in people with advanced lung cancer.

The National Cancer Institute provides a database of more than 100 credible organizations that offer financial, emotional, and practical supportive resources.

Help for Loved Ones

Loved ones and caregivers of people with advanced cancer also face emotional challenges. It’s important to make sure you take care of yourself, too, both physically and emotionally, if you're caring for a cancer patient. You may need extra support if you’re having a hard time coping with the diagnosis.

According to the National Cancer Institute, caregivers of cancer patients may benefit from:

  • A healthy diet
  • Daily exercise
  • Good sleep
  • Talking to other family members or friends
  • Taking 15–30 minutes each day to do something for yourself
  • Joining a support group
  • Accepting help from others
  • Meeting your own medical needs

The American Cancer Society also offers resources for caregivers and loved ones of cancer patients.

Editorial Sources and Fact-Checking

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