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Larry J. Reaves

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In nearly four out of ten patients, non-small cell lung cancer (NSCLC) has already progressed to stage 4 by the time it is detected. This means the disease has spread beyond its original site to other areas of the body, including elsewhere in the affected lung. At that point, the condition may be considered inoperable.

Lung cancer that is deemed inoperable cannot be cured through surgical intervention alone. Other treatment options, such as radiation therapy, chemotherapy, and even drugs in clinical trials, are necessary. Because so many patients are confronted with a diagnosis of stage 4 NSCLC, it is worth being familiar with the physical changes to expect. We'll cover these details below.

When Lung Cancer Spreads To The Bone

In its advanced stages, the disease often spreads to the bone. This causes severe discomfort, and may even lead to small fractures in the bone. At first, the patient may disregard the pain that accompanies bone metastases as being caused by a muscle strain or other factor. But it eventually spreads to other sites, causing widespread discomfort. If the tumor reaches the spine, it may compress the bone and make walking difficult.

The pain can often be relieved with radiation therapy and various medications, such as morphine. However, it is worth noting that treatment is not administered with the primary goal of curing the condition.

Metastasis To The Brain

Lung cancer that spreads to the brain may trigger seizures, difficulty speaking, loss of balance, and other symptoms that are similar to those that present following a stroke. That said, many of those suffering from NSCLC that metastasizes to the brain are absent of symptoms. Unfortunately, this may delay a diagnosis of the disease.

A number of treatment options are available depending on where the tumor is located and the extent of its spread. Radiation therapy is a common choice. If the cancer cannot be seen, an approach called whole-brain radiation therapy is taken. As its name suggests, the radiation is applied to the entire brain. Otherwise, stereotactic radiation therapy is used. The radiation is directed toward the specific area in which the tumor is located. Lastly, if the tumor is in an portion of the brain that is easily accessible, surgery may be done to retrieve it.

When these treatment options are unsuccessful or cannot be applied, the patient is given pain medications to help relieve their discomfort.

Fluid In The Lungs

Patients with non-small cell lung cancer may develop excess fluid in the tissues that line their lungs. This is known as a pleural effusion. While side effects vary, it usually causes chest pain, shortness of breath, rapid breathing, and other respiratory problems.

Once a pleural effusion has been detected, steps are taken to remove the extra fluid. This is often done with thoracentesis (i.e. pleural tap). Unfortunately, the effects are temporary; fluid often returns. Pleurodesis may also be performed, but doing so damages the pleural space. A chemical is used to inflame the tissues, thereby causing the pleural space to close. Chemotherapy and radiation therapy may be administered, but both are often unsuccessful in permanently removing the excess fluid.

Coughing Up Blood

Late stage lung cancer is often accompanied by a bloody cough (i.e. hemoptysis). The blood is usually mixed with mucus. This occurs because the disease causes the air passages to bleed. As with metastases to the bone and brain, treatment is available, but is used to stop or slow the bleeding rather than cure the cancer.

The life expectancy of a patient with stage 4 non-small cell lung cancer is low. However, there are many factors that play a role in determining how long the patient survives. His or her health at the time the disease is detected is important. So too is the patient's response to various treatment options. Young people are more likely to survive than their older counterparts. Women are more likely to survive than men.

If you notice symptoms that may be related to lung cancer, see your physician as soon as possible. Diagnosing the condition before it reaches its final stage dramatically improves the chances for long-term survival.

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CVTSA is a world leading medical practice dedicated to cardiac, vascular and thoracic surgery and treatments. Early diagnosis of lung cancer is essential, so call us today.
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MLA Style Citation:
Reaves, J. Larry "Stage 4 Non-Small Cell Lung Cancer." Stage 4 Non-Small Cell Lung Cancer. 04 Jul. 2012 24 Mar. 2018 <>.
APA Style Citation:
Reaves, J. Larry (2012, July 04). Stage 4 Non-Small Cell Lung Cancer. Retrieved March 24, 2018, from
Chicago Style Citation:
Reaves, J. Larry "Stage 4 Non-Small Cell Lung Cancer." Stage 4 Non-Small Cell Lung Cancer
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