Metastatic Cancer
Stage 4 cancer is the most advanced stage, meaningcancerhas spread to other parts of the body.
When cancer spreads to organs away from the original tumor site, it’s said tometastasize.
That’s why stage 4 cancer is also calledmetastaticcancer.
Verywell / Julie Bang
This article gives an overview of stage 4 cancer.
Stage 4 cancer also can cause more general symptoms, such as extreme fatigue and lack of energy.
Some people become so tired and weak they have trouble doing everyday things.
They may even need help with getting dressed or other routine tasks.
Hearing your healthcare provider call a liver tumor “breast cancer” may sound strange.
But stage 4 cancer is diagnosed based on where the original cancer is located,notwhere it has spread.
For example, breast cancer may spread to lymph nodes under the arm.
Diagnosing Stage 4 Cancer
Oncologistsare doctors who specialize in diagnosing and treating cancer.
Biopsy
A small amount of tissue from the suspected area of spread is removed.
This could be something like breast tissue, skin, or even bone marrow.
It is examined under a microscope for signs of abnormal cells.
Imaging Tests
Images make it possible to view the inside of the body to check a tumor.
This procedure can also help guide a practitioner as they perform a biopsy.
An M score of 1 automatically classifies cancer as stage 4.
Still, prognosis of an M1 case varies depending on the T and N classifications of the cancer.
Substages
Some stage 4 cancers have sub-stages.
For example, stage 4 prostate cancer may be labeled as stage 4A.
This means it has spread to lymph nodes near the site.
Treatment
Stage 4 cancer usually can’t be cured.
The goal of treatment is to prolong survival and improve your quality of life.
Some of the options include surgery, medication (targeted therapy), immunotherapy, and chemotherapy.
Surgery
Surgery typically is not used to treat stage 4 cancer.
In these instances, surgery may relieve symptoms and help prevent the cancer from spreading even more.
Targeted Therapy
Some cancer cells can be treated with medications that target specific proteins or genetic mutations.
These drugs work in different ways.
Testing can determine whether your tumor could respond to any of the available targeted therapy drugs.
Palliative Care
Stage 4 cancer treatment often includespalliative care.
The goal of palliative care is to improve quality of life and increase comfort.
It is provided by a team of healthcare providers and social workers who work with seriously ill patients.
It is not hospice or end-of-life care.
Palliative care may be used in stage 4 cancer pain management.
Stage 4 Prognosis
In many cases, stage 4 cancer can’t be cured.
However, this is not true of all cancers.
Stage 4 testicular cancer, for example, is highly curable.
Lymphomas are highly curable regardless of stage.
How stage 4 cancer is likely to progress (its prognosis) depends on the key in of cancer.
Some advanced cancers are very aggressive and fast-growing.
Some may have fewer treatment options than others.
The outlook for these cases is not likely to be positive.
Survival Rates
One aspect of the prognosis for cancer is calledrelative survival rate.
This can be further broken down by stages of cancer.
SEER does not use TNM to classify cancers.
It refers to cancer that has spread far beyond the original site.
It’s based on a classification system that uses a scale of 0 to 5.
Breast cancer is one such example.
Remission rates for stage 4 cancer vary.
Even if a stage 4 cancer patient goes into remission, the cancer will probably come back.
In cases like these, the stage 4 remission may instead be termedno evidence of disease (NED).
This happens when cancer cells break away from the primary tumor and enter the bloodstream or lymphatic system.
The prognosis for stage 4 cancer, often described in terms of survival rate, typically is not good.
However, it does vary among different types of cancer.
Survival rates for some cancers are low, but they are improving.
The five-year survival rate is 2.7% for men and 4.2% for women.
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