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Oncology treatment

Lung cancer stage 4

Lung cancer, according to statistics, ranks first in the world in cancer mortality among both sexes. This means that malignant lesions of the lungs more often than other tumors lead to the death of patients. For example, in 2020, the disease claimed 1.8 million lives worldwide.
The prevalence is significantly higher among men. The incidence of lung cancer is overwhelmingly associated with smoking. However, in 15% of cases there is no history of smoking, so a hereditary predisposition and the influence of air pollution cannot be excluded.

The high mortality rate from this type of malignant tumor is explained by the fact that lungs' cancer often detected at the last stage, when it has spread to distant organs. A long-term latent course occurs due to the absence of specific symptoms, because such manifestations as cough, shortness of breath, weakness are considered by patients to be manifestations of chronic bronchitis of a smoker, since 85% of them have been smoking for decades.
The prevalence of smoking also explains the increased incidence of lung cancer among men. Even passive smoking increases the likelihood of developing a tumor. Even former smokers with at least 15 years of experience are at risk. Moreover, unfiltered, coarse smoke is considered the most carcinogenic, therefore smoking cigars and pipes increases the risk of developing a malignant tumor the most.

Lung cancer originates from the inner epithelial layer of the bronchi, and according to its cellular composition is classified into small cell and non-small cell. Small cell is rare, but grows quickly and metastasizes, unlike non-small cell.

Depending on the location of the tumor, its manifestations will differ. If the tumor grows in the lumen of a large bronchus or around it, such lung cancer is called central. The malignant process in this case leads to chronic irritation, which can be manifested by a persistent cough. The sputum may contain streaks of blood.

Further growth of the tumor leads to obstruction of the bronchial tube and disruption of ventilation of a segment or an entire lobe of the lung. Poor ventilation of the lung tissue manifests itself in the form of recurring pneumonia. Frequent pneumonia should lead the attending physician to think about a possible tumor cause. Bronchoscopy and tomography will help confirm or exclude suspicions. Fiberoptic bronchoscopy also allows you to take a sample of tumor tissue to determine the cellular composition of the tumor.
Unlike the central one, peripheral cancer is closer to the final sections of the bronchial tree, i.e. near small bronchioles. Malignant growth usually goes unnoticed until the tumor invades the pleura. If cancer grows from the lungs to the pleura, breathing becomes painful and fluid accumulates in the pleural cavity. Tumor pleurisy aggravates shortness of breath, but is well defined by radiography. In the pleura, cancer cells can spread further from the primary tumor: to the chest stack or to the pericardial membrane.

A long asymptomatic course leads to the fact that lung cancer is detected at the last stage, when recovery is unlikely. In the early stages, a tumor is usually detected by chance, during examination for other reasons. Therefore, for risk groups (smokers and people over 55 years of age), regular examination (screening) is considered the best way to detect lesions in a timely manner, and magnetic resonance imaging is recognized as the best method.

If it is possible to detect lung cancer before the fourth stage, when it still remains within the chest, the chances of remission increase. As a radical treatment, surgery remains relevant, and radiation and chemotherapy can be used to reduce the size of the tumor.
In oncology, stage 4 lung cancer is considered inoperable. If metastases are present in distant organs, then there is no point in removing the primary tumor. In such cases, radiation therapy (RT) or chemotherapy (CT), or a combination of both (chemoradiation therapy, CRT) is prescribed. Therefore, the question “Is stage 4 lung disease treated” can be answered in the affirmative. The treatment does not end, but such treatment can no longer be called radical. The goal of antitumor therapy in this case is to prolong life.

Surgical treatment for stage 4 lung cancer. may be required for serious complications. The most life-threatening complication of stage 4 lung cancer is bleeding. Malignant growth leads to the destruction of blood vessels, and the larger the blood vessel, the more fatal bleeding from it can be.

Another serious complication of the disease is compression of the main bronchi or trachea. In this case, breathing is surgically restored, prolonging life. Such operations are called palliative. The tumor can compress not only the trachea, but also the esophagus and the superior vena cava. Accordingly, locally advanced cancer will lead to difficulty breathing, swallowing, as well as disruption of the outflow of blood from the head and upper extremities.


Stage 4 lung cancer is already characterized by metastases outside the chest. The brain is considered the “favorite” place for the spread of lung cancer, so in addition to respiratory disorders, severe neurological disorders caused by a secondary tumor can also be observed. Also, malignant lung disease is accompanied by severe weakness and weight loss. This is explained by the fact that a growing tumor consumes a large amount of nutrients from the bloodstream and pollutes it with waste products of its vital activity. Loss of body weight can reach an extreme degree of exhaustion (cancer cachexia).

The prognosis for patients with lung cancer at the last stage is unfavorable, therefore in oncology they operate not with the frequency of remission, but with indicators of how long patients live after diagnosis.

Author of the article:

Aleksanyan Aleksan Zavenovich

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