Stage 4 lung cancer is the most advanced stage of lung cancer. In stage 4, the cancer has spread, or metastasized, to both lungs, the area around the lungs, or distant organs.
If you or a loved one has received a stage 4 lung cancer diagnosis, you’ll want to know what to expect so you can get the best possible treatment.
期待情绪激增
Along with communicating with family and friends, consider joining a support group or seeking out a therapist or counselor.
Expect to take charge of your healthcare decisions
Many people are motivated to research available information from trusted resources. Then, they might discuss their findings with their healthcare team.
可以进行研究的一个领域clinical trials。这些可能使您获得可以改善您前景的新治疗方法。
Expect to make lifestyle changes
Many people support their treatment by stopping behaviors that are harmful to their health, like smoking. You might also adopt healthy habits, such as staying physically active and incorporating healthy food choices into your diet as much as possible.
Expect some relationships to change
You might find that people start treating you differently than you hoped or predicted. Or you might find yourself needing something different from certain relationships.
Be honest about your needs and seek the support of friends and family you trust.
Expect palliative care
Many lung cancer treatments have uncomfortable or concerning side effects. Sometimes treatment can be adjusted.
Typically, your healthcare team can recommend a palliative care specialist. This is someone who focuses on the management of side effects.
Expect checkups
Even when you’re done with initial treatment, there’ll be follow-up visits, including testing to monitor your recovery.
The most common type of lung cancer is non-small cell lung cancer. According to the
Stage 4 lung cancer is divided into two substages:
- Stage 4ais where the cancer has spread within the lungs or to one area outside the lungs.
- Stage 4bis where the cancer has spread to several places in one or more organs that aren’t close to the lungs, such as the brain, liver, or bones.
根据
Lung and bronchus cancer is the third most commonly diagnosed cancer, behind breast cancer and prostate cancer.
NCI报告说，它约占所有新癌症病例的12.4％，估计在2021年美国约有235,760例新病例。
If you’ve received a diagnosis of stage 4 lung cancer, many factors will affect your outlook, including:
- 总体健康。Commonly, if you’re healthy when you receive your diagnosis, it’s an indication that you might have a better ability to tolerate life-extending treatments.
- Age.Although data regarding the outcomes of older people with lung cancer is limited, a small
2013 study found older age was associated with poorer lung cancer survival. - Gender.根据
ACS , the chances of a woman developing lung cancer sometime in her life are about 1 in 17, while for a man the risk is about 1 in 15. - 种族。The ACS also indicates that while Black women are 14 percent less likely to develop lung cancer than white women, Black men are about 15 percent more likely to develop lung cancer than white men. This may be the result of systemic environmental and healthcare-related factors.
- 对治疗的反应。如果您的身体对癌症治疗的反应良好，那么您的生存机会可能会更高。
- Genetic mutations.According to
2015 research , an epidermal growth factor receptor (EGFR) gene mutation is more common in women and nonsmokers with lung cancer. Targeted drug therapies can treat EGFR and other gene mutations, increasing survival rates. - Lung cancer type and tumor location.肺癌的某些亚型，例如大细胞肺癌，比其他肺癌更具侵略性。根据A
2011 study 。 - Smoking.Asmall 2018 studyfound that people with stage 4 lung cancer who quit smoking cigarettes before starting chemotherapy increased their survival time by as much as 6 months.
- 有能力进行日常活动。Based on the
Eastern Cooperative Oncology Group (ECOG) Performance Status score, people with lung cancer who are able to perform everyday functions may survive longer than those with lung cancer who are confined to a bed or chair more than 50 percent of the time.
Often at this stage, your healthcare team is focused onpalliative careas opposed to curative care.
Late stage 4a lung cancer can cause symptoms such as:
- Fatigue.This can include extreme physical, emotional, and mental tiredness.
- Emotional changes.有些人发现他们对曾经感兴趣的事物的兴趣降低。
- 疼痛。Severe pain and discomfort can occur, but your healthcare team can help you manage the pain to improve your quality of life.
- Difficulty breathing.Shortness of breath and trouble breathing are not uncommon. You can learn techniques that help, and your healthcare team can recommend medication to help relax your breathing and reduce anxiety.
- Coughing.A persistent cough can be caused by a tumor blocking an airway. Your healthcare team can create a treatment plan to help alleviate and manage the coughing.
- Bleeding.If a tumor spreads into a major airway, it may cause bleeding. Your doctor may suggest treatment with radiation or another procedure.
- 胃口的变化。Fatigue, discomfort, and certain medications can lower appetite. You may find that food is no longer as appetizing and that you seem to become full more quickly.
已扩散到其他器官的后期4B肺癌也可能引起以下症状：
- 骨痛或骨折如果散布到骨头
- headaches, vision issues, or seizures if it’s spread to your brain
- nausea, bloating, or jaundice if it’s spread to your liver
作为一名护理人员，您可以期望看到亲人经历上述许多症状和变化，从减少食欲到难以呼吸到情感变化。
Your loved one might also experience spiritual changes, whether they’re religious or not. The
目的是提供以人为本，富有同情心的护理，以改善生活质量以及最佳的健康成果。
Caregiving is often emotionally and physically exhausting. This can lead to feeling overwhelmed and overburdened, a condition referred to ascaregiver burnout。
倦怠的身体体征和症状可能包括：
- 身体疼痛和疼痛
- fatigue
- frequent headaches
- increased or decreased appetite
Emotional signs and symptoms of burnout can include:
- anxiety
- 沮丧
- exhaustion
- 易怒
- lack of energy
It’s important for caregivers to take care of their own health and ask for support and guidance when needed.
Stage 4 lung cancer survival rates measure how many people are living a certain number of years after they were diagnosed with stage 4 lung cancer.
For example, a 5-year survival rate of 6 percent means that people with stage 4 lung cancer are, on average, about 6 percent as likely to survive for at least 5 years as people who don’t have lung cancer.
癌症存活率基于NCI的统计数据
Keep in mind that survival rates are only estimates. Everyone’s body responds to the disease and its treatment differently.
相对生存率也没有考虑到最近的治疗方法。它们基于至少5年前的诊断和治疗。每天都在研究和改进新的治疗方法。
以下
| Stage | 5-year survival rate |
| distant (stage 4) non-small cell lung cancer | 7 percent |
| 所有阶段合并为非小细胞肺癌 | 25 percent |
| Stage | 5-year survival rate |
| 远处（第4期）小细胞肺癌 | 3 percent |
| all stages combined for small cell lung cancer | 7 percent |
The treatment options for late stage 4a or 4b lung cancer vary depending on several factors, such as:
- 癌症已经传播了多远
- 是否发生了任何基因突变
- your health in general
Before treatment for stage 4 lung cancer starts, your tumor may be tested for genetic mutations. According to a
While the following common treatments aren’t likely to cure your lung cancer, they may help you feel better and live longer.
| Chemotherapy | 您可能会单独或与其他疗法结合使用这些药物，例如放射治疗或免疫疗法。 |
|---|---|
| Radiation therapy | This may be used to shrink tumors. It may be used to treat stage 4 lung cancer in people who can’t tolerate chemotherapy. |
| 有针对性的疗法 | Drugs such as EGFR inhibitors and anaplastic lymphoma kinase inhibitors target certain gene mutations in lung cancer cells, helping to slow the growth of tumors. |
| 免疫疗法 | You may take medications called checkpoint inhibitors to help your immune system recognize and attack lung cancer cells. |
| Photodynamic therapy | 轻度和光敏剂可用于收缩尚未散布在肺部之外的肿瘤。 |
| Surgery | 如果肺部或胸腔中的肿瘤以及淋巴结影响，如果它们引起疼痛，可能会通过手术切除。 |