Stage 4 lung cancer means that cancer has spread from the lung to other parts of the body. Treatment may help slow its spread or manage your symptoms.

Doctors stage lung cancer based on how far it has spread in the body. A stage 4 diagnosis means the cancer has spread to one or more distant areas in the body beyond the surrounding lymph nodes.

Lung cancer that was initially diagnosed at an earlier stage can also recur, or come back, and may spread farther throughout the body. Some people may also refer to this as the final stage of lung cancer.

Once it has spread widely, lung cancer is more difficult to treat and unlikely to be cured.

Whether it’s you or a loved one who is facing the final stages of lung cancer, knowing what to expect can help you navigate the process and get the support you need.

Treatment for stage 4 or recurrent lung cancer can depend on many factors. These can include:

  • your overall health
  • specific genetic mutations in the tumor
  • past treatments, if the cancer is recurring
  • where and how far the cancer has spread

If you have stage 4 or recurrent lung cancer, it’s important to talk with your doctor about the goal of treatment and the possible outcomes. At this stage, treatment may help you live longer or relieve symptoms. It usually isn’t expected to cure the cancer.

Treatment options may include:

  • chemotherapy
  • radiation therapy
  • targeted therapy drugs
  • immunotherapy drugs
  • treatment to relieve symptoms, such as inserting a stent or draining fluid from the lungs
  • participation in a clinical trial to try new drugs or combinations of treatments

Some people may decide to stop treatment due to side effects or other reasons. A doctor may also recommend stopping treatment if it’s unlikely to have an effect or if you’re not in good enough health to tolerate it.

At this point, doctors may recommend palliative care. Palliative care focuses on making you comfortable and reducing your pain rather than treating the cancer.

If doctors believe you have fewer than 6 months to live, they may recommend hospice care. Hospice care not only focuses on your physical comfort and pain but also supports your emotional health as you navigate the end of life.

Each person’s experience with late stage lung cancer is unique. The process may be slow and gradual or come quickly.

Symptoms common in people with stage 4 or recurrent lung cancer can include:

  • shortness of breath
  • pain
  • cough
  • trouble focusing
  • confusion
  • extreme weakness and tiredness
  • little interest in eating or drinking
  • restlessness
  • a rattle in the throat and upper part of the chest during breathing
  • fast breathing or pauses between breaths

A doctor or member of a palliative or hospice care team can offer treatments to relieve these symptoms and make you more comfortable.

Not all symptoms in the final stages of lung cancer are physical. It’s also normal to feel anxious or depressed at this stage. You can ask for support from a therapist or other mental health care professional. If you’re spiritual or religious, you may also want guidance from a member of your spiritual or religious organization.

There isn’t one specific way that people with lung cancer die. Cancer occurs when cells multiply much faster than normal. Those extra cells form tumors and may spread to other parts of the body, damaging organs or preventing them from working.

A person’s cause of death from lung cancer can depend on where and how the cancer has spread. For instance:

  • Cancer can damage the lungs to the point where they can’t send enough oxygen to meet the body’s needs. Or a large tumor can block the lungs and make it hard to breathe.
  • Sometimes bacteria can cause infections like pneumonia to grow when there is a blockage in the lungs. The body may be too weak from the cancer to fight off the infection.
  • A tumor can also block a blood vessel. This blockage can slow or stop the flow of blood to the lungs and other parts of the body.
  • Lung cancer can also spread to organs like the liver. Damage to the liver can prevent it from removing toxins from the blood, helping the body store energy, or producing necessary cholesterol and proteins.
  • Cancer that spreads to the brain can also be fatal. The brain controls all of a person’s vital functions, including breathing.

Hospice care can help make a person comfortable until their final moments by managing their pain or sedation levels.

According to the American Cancer Society, the average 5-year relative survival rates for lung cancer that has spread to distant locations in the body include:

  • non-small cell lung cancer: 9%
  • small cell lung cancer: 3%

These figures are based on people who received a diagnosis between 2012 and 2018.

A 5-year relative survival rate reflects the percentage of people with a type and stage of cancer still alive 5 years after their diagnosis compared with people without that cancer.

These numbers are an average based on all the people with a diagnosis of a type of lung cancer. Many personal factors can include how long a person lives with lung cancer, including:

  • overall health
  • age
  • specific genetic mutations of the cancer
  • where the cancer has spread

It’s also possible that people who receive a diagnosis now may have a better outlook than these numbers suggest based on improved treatment, monitoring, and detection. It’s best to talk with your oncologist to better understand your individual outlook.

According to a 2021 study, the median survival of people with stage 4 non-small cell lung cancer without treatment was about 16 months.

However, how long a person survives without treatment can depend on many factors and be hard to predict.

Having stage 4 or recurrent lung cancer can be difficult physically and emotionally.

A 2021 study suggests that earlier palliative care may improve a person’s quality of life with stage 4 lung cancer. Palliative care aims at relieving symptoms rather than treating the cancer. Hospice care, while similar, is only available to people whom a doctor believes have 6 months or fewer to live. It may be offered at home or at a hospice facility.

Both types of care involve care teams that provide physical and emotional support for the person with lung cancer and their loved ones. They can connect you with therapists and counselors who can provide guidance.

Someone with later stage lung cancer may have needs that vary by the day. You can take steps to help them become more comfortable and be a comforting presence when they need one.

A person with end stage lung cancer may not be able to move around on their own. You can help see that their needs are met and help them with:

  • eating
  • drinking
  • administering pain medications
  • changing their position
  • managing eliminations (urine, stool)
  • applying lip balm if they need it
  • providing ice chips for dehydration if desired

Your loved one’s care team can provide more specifics on how to care for them in hospice care.

A person may be at the final stages of lung cancer if they have stage 4 lung cancer or lung cancer that has recurred and spread. Depending on the individual circumstances, a doctor may recommend certain types of treatment.

A person’s outlook with stage 4 lung cancer can vary from one person to the next. It can depend on many factors, including age, overall health, and specific genetic information about the cancer itself.

If you reach a point where treatment is no longer effective or you choose to stop treatment, you can begin palliative or hospice care. Both types of care focus on managing your symptoms and quality of life. However, hospice care is only available to people who may have 6 months or fewer to live.

Whether it’s you or a loved one who is facing the final stages of lung cancer, it can be a very emotional time. Make sure you have all the support you need from your friends and family, doctors, and other members of your healthcare team.