Lung Cancer Classification – What Is Stage IV?
It is a SAD fact that the general prognosis for a late-stage (stage 4) lung cancer patient is not very good at all. Although, it should be noted at this point, some late-stage patients do seem to pull something out of the hat and respond well to treatment (in general, when talking about late-stage lung cancer, it is usually assumed to be non-small cell [NSCLC] – the most commonly diagnosed type).
NSCLC is usually responsible for 80% + of all cases diagnosed, whereas small cell lung cancer (SCLC) is usually only responsible for under 20% of cases(SCLC is the least common and more deadly of the two types). Mixed cell/large cell lung cancer is a mixture of both SCLC and NSCLC.
Stage 4 – indicates that the cancer has metastasized from its origin to another part/s of the body (outside of the chest area). However, sometimes certain situations will arise in its development that allows for a patient to have a better out-come (usually only with NSCLC patients). For example:
When the metastasis of the cancer is limited in size and number, it may be possible to treat it with modern aggressive directed treatments.
When bronchioloaveloar (BAC) is present in a patient (a type of non-small lung cancer), due to it being very slow-growing – often a patient can be monitored without the need for treatment (sometimes for many years).
Where non-small lung cancer is present, molecular testing is usually carried-out to determine ALK mutations (mutations in the ALK gene change single protein building blocks [amino acids] in anaplastic lymphoma kinase – 5% of patients are usually affected), and EGFR ([epidermal growth factor receptor] 15% of patients are usually affected). TKI([s] medicine may be used to target the mutations for a prolonged control of the cancer (Xalkori and Tarceva).
Under certain circumstances, a patient may have late stage NSCLC that is sensitive to chemotherapy (prolonging prognosis [life-expectancy] due to the treatment being more successful).
However, in general, a stage 4 NSCLC diagnosis will mean a short prognosis (related factors to an individuals prognosis [taken on a one by one basis] include: age, general health, treatment choice and response, and the characteristics of the tumor). But, as a general rule-of-thumb, the following could be considered to be normal in most cases:
Non-small cell lung cancer (stage 4) – low prognosis (only 10% – 15% of sufferers will be seen to still be alive 5-years after diagnosis).
Small-cell lung cancer (stage 4) – very low prognosis (only 5% – 10% of sufferers will still be seen to be alive 5-years after diagnosis [2 – 4-months if left untreated]).
Lung Cancer One-Year Survival Rate Improves in the United Kingdom
In general – the 5-year lung cancer survival rates for patients in the United Kingdom have slowly been improving. Recent data released by the Public Health England’s National Cancer Intelligence Network – recently said that near twice as many lung cancer patients lived over 12 months (2011 figures) than those who were diagnosed with lung cancer in 1990.
Early diagnosis and improved treatments are seen to be behind these new figures – it was explained. And, although lung cancer incidents in men have been seen to be on the decline – those in women have risen. Since the 1970s, lung cancer diagnosed in women has been on the increase by around 73%, while those in men during the same period have decreased by 47% (mainly due to the different smoking trends between men and women [women are smoking more these days]).
Although there has been an improvement in both early diagnosis and treatment of lung cancer, it is still the number-1 killer in the U.K., and the second most common cancer diagnosed after breast cancer. However, Dr Mick Peake, of the National Cancer Intelligence Network disclosed the following figures:
17% of 1990 lung cancer patients were still alive one-year after being first diagnosed with the disease (compared with 29% of men, and 33% of women in 2010). However, there seemed to be little change in the overall 5-year survival rate that still hovers around the 10% -11% figure.
Smoking is still considered to be the main culprit that kills around 28,000 of the 35,000 that die every year in the U.K. due to lung cancer.
Apart from the early detection of the disease, one of the main improvements for the short-term one-year figures seems due to the improvement in treatments, such as biological therapies that have been designed to help stop the metastasis (spread) of cancer cells, and newly developed techniques that allow for cancer cells to be frozen – cryotherapy.
Treatments most often depend upon the stage at which the disease was diagnosed in a patient, together with other factors too. For example: age, gender, health, and patient history, all being important factors that help decide which treatment may be more suitable (each individual will be accessed on a one-by-one basis, as what may work for one, may not work for another [general guidelines will apply]).
Dr Mick Peake, from the National Cancer Intelligence Network, said “This report shows that we are gradually making inroads into improving the survival rates of this common cancer; however, there is much more to be done for lung cancer patients with the majority still dying within a year of diagnosis.”
It was also commented by Nick Ormiston-Smith, Cancer Research U.K’s head of statistics, that “It’s great news that lung cancer in men has fallen by more than a third since the early 1990s.”
He further went on to talk about the trends in lung cancer incidence rates reflecting past trends in cigarette smoking, where many men actually quit smoking during the 1950s and onwards, which in his words, said “we are now seeing the positive impact of that, but unfortunately this smoking fall didn’t occur for women until later, etc.”
Although, one-year survival rates are now approaching those of other countries, where previously – historically they had shown better results, smoking by youngsters is still seen to be a problem (better awareness among the young should be a priority).