As we know that not all lung cancers are the same. Not even all NSCLCs are the same. There are more targeted treatments in studies or coming to market all the time. As a patient, it's super important to stay on top of the research (worldwide) and it's difficult for general oncologists to be up to date on all possible therapies. Bring your research to your oncologist to start the conversation about new treatment options. For the record I have stage IV EGFR NSCLC without metastasis. I have been living with NED results for three years on Alimta (and for a while Avastin) as maintenance.
Unfortunately the general prognosis is not good but there are individuals that still can do exceptionally well with treatment, and I've personally seen that happen in my practice. When someone asks about lung cancer, I assume the question is about non-small cell lung cancer. Stage 4 indicates that the cancer has spread outside of the chest to other areas; it has metastasized.
There are certain situations where some patients with stage 4 lung cancer can have a significantly better outcome than average:
1. Some stage 4 cancers can be treated with aggressive directed treatments because the areas of spread (metastasis) are limited in size and number. For example, a patient could have an isolated metastasis to the brain and otherwise have an operable cancer in the lung that allows for complete removal. Anything less than complete removal is usually not helpful. The lung cancer is removed by a thoracic surgeon. The brain metastasis is either removed by a neurosurgeon or treated by a radiation oncologist with steriotactic radiation.
2. Some patients have a kind of non-small cell lung cancer called bronchioloaveloar (BAC). These cancers can sometimes grow very slowly and patients often can be monitored without needing treatment for a number of years.
3. Molecular testing is mandatory now for non-small cell lung cancer. About 5% will have ALK mutations and maybe 15% have EGFR. There are pills called TKI(s) that can target these mutations and some patients can have prolonged control of their cancers using these pills (Xalkori and Tarceva).
http://www.nationallungcancerpar...
4. Occasionally someone with stage 4 lung cancer has a cancer that is uniquely sensitive to chemotherapy and even with extensive wide spread metastasis can have scans that become normal and long survival.
Most stage 4 lung cancer situations are considered poorly curable. Lung cancer is a common cancer in America and most oncologists are very knowledgeable in treating this problem. If you have any questions or concerns about the diagnosis or treatment recommendations, it would be reasonable to seek a second opinion at a university affiliated cancer center.
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