Stage 4 cancer is an advanced cancer. That means the cancer has spread to different areas of your body. Treatment options depend on the type of cancer and may be able to slow the growth of the cancer and improve quality of life.

Most cancer is often described in terms of stages. These stages are usually grouped numerically from 0 to 4, with stage 4 being an advanced cancer. Stages offer information about a cancer’s size, location, how far it has spread, and whether it has affected nearby organs or tissues.

Cancer stages are determined by using physical exams, imaging scans, and other tests that can offer information about a cancer’s status.

A cancer’s stage can also help a medical team decide on a course of treatment and determine how successful a certain treatment might be. For example, an early stage cancer might respond best to surgery and radiation, while a stage 4 cancer might respond better to chemotherapy or targeted therapy.

While cancer staging is important, many factors will affect your outlook. Your age and overall health, how the cancer responds to treatment, and the characteristics of specific cancers all play a role in the outcome.

Stage 4 cancer, or metastatic cancer, is an advanced cancer. This usually means that the cancer has spread beyond its original location into nearby organs or other distant parts of the body.

Although this advanced stage of cancer requires expert care, people may live for several years after treatment. The outlook and treatment options for people with cancer differ based on the specific type of cancer. These differences also affect the overall survival rate.

At stage 4, treatment options depend on the type and location of the cancer, a person’s overall health, and the cancer’s overall response to treatment. Typically, the goal of stage 4 treatment is to:

  • slow or stop new growth of cancer cells
  • reduce or relieve a person’s symptoms
  • minimize complications
  • improve quality of life

Most cancers are typically grouped in stages from 0 to 4, with 4 indicating the most advanced stage of cancer. In general terms, the stages of cancer are:

  • Stage 0 (carcinoma in situ): Abnormal cells are found but they haven’t spread.
  • Stage 1: This is early stage cancer. It hasn’t grown deeply into nearby tissues.
  • Stages 2 and 3: In these stages, cancer has grown more deeply into nearby tissues. It may also have spread to lymph nodes but not to other areas of the body. These stages are more defined for specific cancer types.
  • Stage 4: This is an advanced cancer stage. The cancer has spread to other organs or parts of the body.

The cancer stages above are determined after identifying a cancer’s TNM stage. The TNM system specifics are different for each type of cancer, but it uses letters and numbers to describe:

  • The tumor (T): The letter “T” is followed by a letter, number, or combination of both that will answer certain questions about the tumor size, location, or whether it has grown into nearby tissues or organs.
  • The lymph nodes (N): The letter “N” is often followed by a number from 0 to 3, indicating whether the tumor has spread to any nearby lymph nodes and, if so, how many lymph nodes have been affected.
  • Metastasis (M): The letter “M” and the number after it indicates whether the cancer has spread and how far it has spread. These numbers go from 0 to M1, with 0 meaning the cancer hasn’t spread and M1 meaning the cancer has spread.

Additionally, some cancer types are categorized by grade, usually going from grade 1 to either grade 3 or grade 4. A cancer’s grade describes to what degree cancer cells look like healthy cells, with a higher grade indicating a more advanced cancer.

Healthy cell tissue often contains many types of cell groups together. If cancerous tissue looks like healthy tissue with many different cell groups, it’s considered a low grade tumor. If the cancerous tissue looks very different from healthy tissue, it’s considered a high grade tumor.

Cancer with a higher grade is usually thought to be at risk of spreading more quickly. Different cancer types will have different ways of assigning grades.

Are all cancers staged?

Not all cancers are staged. Staging is a way to measure how far a cancer has spread throughout the body. Cancers involving full body systems, such as leukemia, a cancer of the blood, have already spread throughout the body at the time of diagnosis. These cancers use other methods to measure a cancer’s progress.

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The treatment and outlook for people with stage 4 cancer depend on the specific type of cancer being treated. In general, the goals of stage 4 cancer treatment are to stop or slow the cancer’s spread, manage cancer symptoms or complications, and improve a person’s quality of life.

There are several treatment options available for stage 4 cancer. These methods can either be used individually or as combined treatments, depending on the nature of the cancer.

  • Chemotherapy: Chemotherapy is often the only choice for someone with advanced stage cancer. The dose and frequency can be adjusted according to the potential risks, side effects, and individual preferences.
  • Radiation therapy: Radiation therapy is often used in combination with surgery or chemotherapy and may help shrink tumors and ease symptoms.
  • Surgery: Surgery isn’t often used in stage 4 cancer unless the tumor sites are small and the surgery might help relieve symptoms and prevent further spread.
  • Immunotherapy: Immunotherapy can help your immune system fight cancer and is used more in advanced stage cancers. There are different immunotherapy treatments and success rates for different cancer types.
  • Targeted therapy: Targeted therapy is precision medication that targets certain cancer proteins and affects their growth. It can treat many different types of cancer and may be used in combination with other treatments.
  • Hormone therapy: Hormone therapy can be used in cancers that rely on hormones in order to grow, such as breast and prostate cancers. When used with other treatments, it may reduce a tumor’s size, lower the risk of recurrence, or even destroy cancer cells.

Survival rates for stage 4 cancer depend on the type of cancer, its grade, how well the cancer responds to treatment, your age, and your overall health.

Here are general stage 4 relative survival rates for common cancer types:

Cancer type5-year relative survival rate
Breast cancer30%
Non-small cell lung cancer9%
Prostate cancer32%
Colorectal cancer16%
Melanoma (skin) cancer30%
Cervical cancer17%

Stage 4 cancer is an advanced cancer. It means that the cancer has spread beyond its original location and into other areas of the body. Stage 4 cancer isn’t usually curable, but treatment may improve overall survival and quality of life.

Treatment options and survival rates for stage 4 cancer greatly depend on the type of cancer, how well it responds to treatment, a person’s overall health, and several other factors. Treating stage 4 cancer can include a combination of therapies such as surgery, chemotherapy, radiation, immunotherapy, or targeted therapy.

Each type of cancer is different. Work closely with your healthcare team to understand all your options.