Stage 4 Lung Cancer Treatments

Stage 4 lung cancer treatments are more serious than other stages of lung cancer. The most advanced stage of lung cancer is stage 4 non-small cell lung cancer that has metastasized. It has spread to another area of the body. Approximately 40% of patients diagnosed with lung cancer are in stage 4. This type of lung cancer is not curable. However it is treatable.

Stages of Lung Cancer

Before we discuss stage 4 lung cancer treatments, let’s look at the different stages of lung cancer.
Doctors who specialize in cancer are called oncologists. They use a TNM system to classify lung cancer. The T stands for the tumor size.

• T1 is a tumor less than 1.5 inches
• T2 is a tumor greater than 1.5 inches
• T3 is a tumor that is any size, BUT is near an airway, the chest wall, or the diaphragm
• T4 is a tumor that is any size, BUT has spread to the heart or the esophagus. The cancer might also be in the space between the layers lining the lungs.

The N in TNM stands for the lymph nodes.

• N0 means no nodes are cancerous
• N1 means the cancer has spread to nearby nodes on the same side of the body
• N2 means the cancer has spread to farther nodes on the same side of the body
• N3 means the cancer has spread to nodes on the other side of the chest, or near the neck

The M in TNM stands for metastases.

• M0 means there is no metastases
• M1 means the cancer has metastasized to other parts of the body

Using this TNM system, stage 4 can be described as: T (any), N (any), and M1. This means there is a tumor of any size, with or without lymph node involvement, which has metastasized to another part of the body.

Symptoms of Stage 4 Non-Small Cell Lung Cancer

Some of the symptoms from a tumor in your lung might be:

• Persistent cough
• Cough that produces blood
• Shortness of breath
• Hoarseness
• Pains in the chest, or back, or arms
• Repeated pneumonia or bronchitis
• Wheezing

Some of the symptoms from metastasized cancer are:

• Fatigue
• Weight loss
• Loss of appetite

Treatment of Stage 4 Non-Small Cell Lung Cancer

Early lung cancer treatment is best because it is most treatable. But, there are no symptoms for early stage lung cancer. There is no blood test to confirm the presence of lung cancer. That is why so many people who are diagnosed are stage 4.

Stage 4 lung cancer is usually inoperable because the cancer cells have migrated beyond the lung tissue. However, stage 4 lung cancer treatments include:

• Chemotherapy
• Radiation therapy
• Biologic therapy

Stage 4 NSCLC is widespread when it is diagnosed. Cancer that has spread widely throughout the body is treated with chemotherapy. The general health and stamina of the person determine the type of drug.

The targeted therapy of Avastin (bevacizumab) is FDA approved for stage 4 lung cancer if the patient is not at high risk for bleeding. The drug Erbitux (cetuximab) is a second choice for chemotherapy. Docetaxel or pemetrexed may also be tried.

For patients who cannot tolerate chemotherapy, radiation therapy is the treatment recommended. External radiation with x-rays by way of computed tomography (CT) is probably your best option. It does not hurt and it is targeted for the part of the body where the cancer cells are congregated.

Stage 4 lung cancer treatments also include a drug called erlotinib (Tarceva). It is a type of biologic therapy called a tyrosine kinase inhibitor (TKI). These molecules are proteins that cells use to signal growth. They act as chemical messengers.

Erlotinib is a pill that you take once a day before or after eating. Skin rash, diarrhea, loss of appetite and fatigue are the common side effects you may experience if you take this drug.

Other Treatments for Stage 4 Cancer

In addition to chemotherapy and radiation therapy to control the symptoms of your lung cancer, there are other possibilities. Internal radiation therapy is known as brachytherapy. A thin tube with small seeds of radioactive material is placed in your lung.

Then, there is cryotherapy where they try to freeze the tumor with liquid nitrogen. A stent, which is a rigid tube, can be placed to keep an airway open. Finally, photodynamic therapy uses light to kill cancer cells.

So, even though early lung cancer treatment is best, you can get relief from your symptoms with the various stage 4 lung cancer treatments.

Written by Margaret Stenerson-Reynolds
Reviewed by Susan McCracken