Stage 4 cancer, or metastasis cancer, is the most advanced cancer stage. Cancer cells metastasize to other body parts away from the original tumor site in this stage. This stage may be detected years after the initial cancer diagnosis and after primary cancer has been treated or removed. The prognosis of stage 4 cancer is not always good. However, many people can live for years after diagnosis. It is the most advanced stage; it needs the most aggressive treatment. Stage 4 cancer can sometimes be terminal cancer. Some experts may refer to this stage as an end-stage of cancer. If a doctor confirms that the cancer is terminal, this usually means that the cancer is at the advanced stage, and the treatment options focus on controlling rather than curing cancer.
Even though cancer is metastasized to the other part of the body in stage 4 cancer, it is still described by its original location. For example, if breast cancer cells reach the brain, it is still considered breast cancer, not brain cancer. Many stage 4 cancers have various subcategories, such as stage 4A or stage 4B, often determined by how cancer has metastasized to other body parts. Likewise, stage 4 cancers are often mentioned as metastatic adenocarcinomas.
This article will define stage 4 cancer and how it is diagnosed and treated. It will help you learn about treatment and possible stage 4 cancer outcomes.
Survival rates for common cancers in stage IV
Survival rates mean the likelihood of living for a certain period, such as five years after a doctor diagnoses cancer. If the doctor says that the five-year survival rate for people with breast cancer spread to distant body areas is 28%, it reflects that 28% of people survive for this period. Survival rates may vary based on the type of cancer. The five-year survival rate for mesothelioma spread to other body parts is 7%. This rate is 3% for distant pancreatic cancer.
However, it is worth noting that these rates are obtained from past data; they may not reflect the most recent advances in treatment. Also, a wide range of factors influences each person’s life expectancy.
One aspect of the prognosis for advanced cancer is called relative survival rate. This refers to the percentage of people with a particular diagnosis likely to live a specific amount of time. The rates for advanced cancers are based on statistics published in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program database.
SEER does not use TNM to classify cancers. Instead, it uses three stages—localized, regional, and distant—with “distant” generally meaning the same thing as stage 4. It refers to cancer that has spread beyond the original site or nearby tissue or lymph nodes. For most types of cancer, SEER uses five-year survival rates.
Cancer’s spread will often begin in the same region where the original cells were found. For example, breast cancer may spread to lymph nodes under the arm. Common sites of cancer metastasis include:
Lung cancer: This is located in adrenal glands, bones, brain, liver, and the other lung.
Breast cancer: It is found in bones, the brain, liver, and the lungs.
Prostate cancer: It is located in the adrenal glands, bone, liver, and lungs.
Colorectal cancer is found in the liver, lungs, and peritoneum (lining of the abdomen).
Melanoma: It is located in bones, the brain, liver, lungs, skin, and muscles.
Treatment for stage 4 cancer
Treatment for stage IV cancer depends on the tumor’s location and the organs involved. It becomes difficult to treat if the cancer cells spread from the site where it was first diagnosed. Patients diagnosed with stage 4 or metastatic cancer may not survive without treatment.
Options to treat stage 4 cancer may involve chemotherapy, radiation therapy, hormone therapy, surgery, immunotherapy, targeted therapy or combining these modalities. The purpose of treatment is to prolong survival and improve quality of life. An oncologist will treat cancer depending on its type, where it has spread, and other factors.
Chemotherapy is given to a cancer patient to kill a small number of cancer cells. It is usually less effective in eradicating a larger number of tumor cells present in widespread metastases. If cancer has spread to only a few small areas, surgeons may be able to remove it to prolong the patient’s survival. In most cases, treatment of stage IV cancer is aimed at prolonging patients’ survival and improving their quality of life.
Radiation therapy is given at high doses to kill cancer cells or slow their growth by damaging the DNA of the cells. When the DNA of a cancer cell is damaged beyond repair, it stops dividing and dies. Dead, damaged cells are broken down and rejected by the body.
Radiation therapy does not kill cancer cells directly. After the DNA is damaged, treatment takes days or weeks, leading to cancer cells’ death. Cancer cells continue to die for weeks or months after radiation therapy gets over. Radiation therapy is used to treat cancer and ease cancer symptoms. When used to treat cancer, radiation therapy can cure, prevent it from returning, or stop or slow its growth.
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Hormone therapy is a type of cancer treatment. It slows or stops the growth of a tumor that uses hormones to grow. This therapy is also called hormonal therapy, hormone treatment, or endocrine therapy. Hormone therapy reduces the chance of cancer cells returning. This therapy also stops or slows cancer growth. It eases cancer symptoms. Hormone therapy also reduces or prevents symptoms in men with prostate cancer who cannot have surgery or radiation therapy.
Surgery generally is not used to treat stage 4 cancer, as cancer cells spread in different body parts in this stage. However, if the cancer cells are scattered in a small area, and the number of cancer cells is less, they can be removed with surgery. But usually, they can be removed along with the primary tumor. Surgery may relieve symptoms and help prevent cancer from spreading even more.
Targeted therapy is a cancer treatment that targets proteins that control cancer cells’ growth, division, and spread. It is the foundation of precision medicine. As researchers learn more about the DNA changes and proteins that drive cancer, they can better design treatments that target these proteins. Most targeted therapies are either small-molecule drugs or monoclonal antibodies. Small-molecule drugs are small enough to enter cells quickly and are used for targets inside cells. Most types of targeted therapy help treat cancer by interfering with specific proteins that help tumors grow and spread throughout the body.
This treatment targets drugs that use our immune system, including blood proteins, namely antibodies, to attack cancer cells. Immunotherapy drugs are used for different types of cancer, including bladder, breast, colon and rectum, kidney, liver, lung, and blood (leukemia, lymphoma, and multiple myeloma) prognosis.
Cancer research and technology have advanced a lot in the last two decades. It has shown that there is hope for the future. Each year, new data emerges from a scope of technology that is ever-expanding, helping to provide patients with a new lease on life. However, like any further information, it is essential to evaluate it judiciously and be realistic about what is possible. It is also significant to remember that there is still life after a cancer diagnosis, even stage IV.
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