Stage 4 Lung Cancer Life Expectancy

Understanding Prognosis After Lung Cancer Has Spread

If you or a loved one have been diagnosed with stage 4 lung cancer, one of the first questions that comes to mind may be, "What is stage 4 lung cancer life expectancy?" While cancers that are stage 4 have the reputation of being "bad," you may wonder what this really means.

Those who suddenly learn they have stage 4 lung cancer are not alone. Roughly 40 percent of people with lung cancer are diagnosed when their cancer is already stage 4, which means that the cancer has metastasized (spread) throughout the body. For example, tumors may be present in the brain, bones, or liver.

Stage 4 Lung Cancer Survival

It's important to point out a couple things before we discuss all the facts and figures. First, everyone is different—there are many variables that can affect lung cancer survival. And second, statistics regarding lung cancer survival are not necessarily as meaningful as they may have been just a few years ago, which can be a good thing. Many new treatments may have since been approved.

variables that affect stage 4 lung cancer survival
Illustration by Emily Roberts, Verywell

Stage 4 lung cancer life expectancy can vary considerably among different people, even among people who have the same type and stage of lung cancer. Let's explore these variables in more depth.

Type and Location

Stage 4 lung cancer encompasses several lung cancer types. It also includes cancers that have spread to only one distant region or those that have spread extensively.

Survival can also be affected by the genetic characteristics of the tumor, with cancers that have "targetable mutations," such as ALK-positive lung cancer, ROS1 mutations, and EGFR mutations, being more likely to respond to the newer targeted therapies for lung cancer. Cancers that have a high tumor mutation burden on testing are more likely to respond to immunotherapy drugs.

Looking at subtypes of lung cancer when estimating prognosis can't be understated. For example, a December 2018 study found that people who had ALK positive stage 4 lung cancer had a median survival rate of 6.8 years with the right care, even when brain metastases were present.


Younger people tend to live longer than older people with lung cancer. Actually, lung cancer in young adults is different in many ways.


The life expectancy for a woman with lung cancer is higher at each stage of lung cancer.

General Health at Diagnosis

Being healthy overall at the time of diagnosis is associated with a longer life expectancy as well as a greater ability to withstand treatments that may extend survival.

Response to Treatment

Side effects of treatments such as chemotherapy, surgery, targeted therapies, immunotherapy, and radiation therapy vary among different people and may limit your ability to tolerate treatment.

Other Health Conditions

Health conditions, such as emphysema, may lower stage 4 lung cancer life expectancy.


Complications, such as blood clots, can lower stage 4 lung cancer life expectancy.

Where It Spreads

Lung cancer can spread to nearly any region of the body, but most commonly spreads to the brain, bones, liver, and adrenal glands. When only a few lung cancer brain metastases or liver metastases are present, treatment with the goal of long-term survival is sometimes possible. In general, metastases to the adrenal glands, especially adrenal glands on the same side of the body as the lung cancer, have a better prognosis than metastases to other regions.

A Look at the Statistics

In addition to variations between different people, it is important to keep in mind that statistics are frequently based on people treated a few years back. For example, the most recent statistics we have for lung cancer from 2018 are based on people diagnosed with lung cancer during a period ending in 2014. Since that time, new treatments have been approved for people with advanced lung cancer, and even more treatments are being studied in clinical trials. 

The median stage 4 non-small cell lung cancer life expectancy—the time at which 50 percent of patients are alive and 50 percent have passed away—is only around eight months. The five-year survival rate—that is, the percent of people who are expected to be alive five years after a diagnosis of stage 4 lung cancer—is sadly only 4 percent.

While the numbers may sound low, there are many people who are long-term survivors of stage 4 lung cancer. Every year at the HOPE Summit in Washington, D.C. (a wonderful group of lung cancer survivors that anyone can become a part of), photos confirm not only a multitude of lung cancer survivors who are thriving with lung cancer, but a double-digit number group of people who have survived stage 4 disease for at least 10 years. 

Remember, you are not a statistic. There is hope—and it is not false hope.

Lung Cancer That Has Spread

There is one last thing to keep in mind that is very important. While stage 4 lung cancer is not usually curable, it is treatable. These treatments may not only improve survival but may also help with the symptoms of lung cancer as well.

The approval of two immunotherapy drugs in 2015 (and two other immunotherapy drugs approved since that time) suggests that long-term control of advanced lung cancer may be possible for some people. For those with targeted mutations, switching to newly developed drugs when tumors become resistant also suggests that advanced lung cancer may one day be treated as a chronic disease, such as diabetes, for some people.

Another recent advance for lung cancer that has spread is the treatment of "oligometastases." When a single—or only a few—metastases are present, for example, in the brain or the liver, techniques such as stereotactic body radiotherapy (SBRT) may be used to eliminate these metastases. This technique has even resulted in long-term survival for some people with brain metastases from lung cancer.

Improving Your Survival

After many years of little progress in the treatment of lung cancer, options for treating and personalizing lung cancer care have increased exponentially. What this means is that it is hard for anyone—even an oncologist who specializes in cancer—to be aware of every new advance and clinical trial being conducted around the globe.

lung cancer survival rates
Illustration by Hetal Rathod, Verywell

Studies suggest that people who learn as much about their cancer and become their own advocate in their cancer care may have better outcomes. An excellent way to not only receive support but to find out about the latest advances in treatment is to become involved in a lung cancer support group or support community.

The hashtag for these groups is #LCSM, which stands for lung cancer social media. In addition, several of the lung cancer organizations have joined together to provide a free clinical trial matching service for those living with lung cancer. Make sure to check out the above tips on advocating for yourself as a cancer patient whether you are living with lung cancer yourself or facing lung cancer together with a loved one.

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