What Is Stage 4 Cancer?

Cancer occurs when abnormal cells grow uncontrollably, forming masses and spreading throughout the body. Your doctor will assess the severity of the cancer using a staging system, taking into consideration factors such as the tumour's location, size, and extent of spread. Stage 4 cancer, also known as metastatic cancer, is the most advanced stage, characterised by the fact that cancer cells have spread to other organs or distant parts of the body.

What Is Cancer Staging?

The cancer staging process is used by medical professionals to categorise the extent and severity of a patient's cancer, providing important information for determining the best treatment plan and predicting how the disease is likely to progress. This grouping process is done after diagnosis, before treatment begins. 

Your doctor will combine information that was used for your diagnosis with any additional information still required. This means that you may need to do further assessments such as imaging and lab tests. 

There are many methods and systems for staging. One of the most common ways to stage a cancer is using the TNM system, which categorises the cancer using a combination of numbers and letters in various ways (depending on the type of cancer). This system utilises detailed information about the tumour, nodes and metastasis. These details can then be grouped more broadly into 4 categories or ‘stages’.

• Stage 1 (I): Generally indicates that the cancer is small and contained within the organ where it started (no spread).

• Stage 2 (II): Generally indicates a larger tumour (compared to stage 1), but that the cancer has not spread into surrounding tissue. However, depending on the type of cancer, Stage 2 could also refer to cancerous cells having spread to the nearby lymph nodes. 
• Stage 3 (III): Generally indicates a larger cancer, possibly one which has spread into nearby lymph nodes as well as surrounding tissues.
• Stage 4 (IV):  Also called secondary, advanced, or metastatic cancer. Generally indicates that the cancer has spread from where it began to at least one other organ.
• Stage 0: Some cancers have the option of a stage 0. This stage indicates that abnormal cells are present, but have not spread from the layer of cells where they started (in situ). 

What Does Stage 4 Mean?

As seen above, Stage 4 cancer indicates that the cancer has spread from its original location to at least one other organ or distant area of the body. This stage is generally associated with a poor prognosis (compared to earlier stages), as the cancer is more challenging to treat and control. However, each cancer type is staged differently which means that a stage 4 categorisation for one cancer may not communicate the exact same information as stage 4 for another cancer. 

What Is The Prognosis For Stage 4 Cancer

A prognosis is an estimate of how your cancer will develop, how it may affect you, and how treatment could progress. Doctors use various factors to determine the prognosis, such as the cancer stage, grade, type, and your overall health. 

While stage 4 cancers usually have a lower survival rate and shorter life expectancy than earlier stages, every individual's experience with cancer is unique, and many factors can influence the disease and treatment path.

How Is Stage 4 Cancer Treated?

As it is the most severe stage, stage 4 cancer is often considered incurable. However, there are several treatments available which can help to manage symptoms, improve your quality of life, and possibly extend survival. Common treatment options include:

Surgery

In some cases, surgery may be performed to remove tumours or alleviate symptoms. However, as stage 4 cancer has spread to other organs, surgery is often not a curative option.

Chemotherapy

This treatment uses drugs to kill or slow the growth of cancer cells. Chemotherapy can help control cancer growth, shrink tumours, and alleviate symptoms.

Radiation Therapy

High-energy radiation is used to kill cancer cells or reduce tumour size. Radiation therapy can be helpful in relieving pain and other symptoms caused by tumours pressing on nerves or organs.

Targeted Therapy

These medications specifically target cancer cells or processes that promote cancer growth, leaving healthy cells relatively unharmed. Targeted therapies are available for several types of cancer, including breast, lung, and colorectal cancers.

Immunotherapy

This treatment approach aims to stimulate your natural immune system, in order for it to more effectively recognise and attack cancer cells. Immunotherapies are available for several cancer types, including melanoma, lung cancer, and some lymphomas.

What Is Palliative Care?

Palliative care is a medical care framework which focuses on providing relief from symptoms, pain, and stress related to serious illnesses such as stage 4 cancer. The main goal of this approach is to improve quality of life, regardless of the prognosis. These interventions can be given alongside curative treatments, offering benefits at any phase of the illness. 

The main aspects of palliative care are pain management, symptom control, emotional support, and help with decision-making, including communication between loved ones, medical staff, and the patient, ensuring that your needs and preferences are considered. 

Coping With A Stage 4 Cancer Diagnosis

A stage 4 cancer diagnosis can be emotionally and practically challenging for both you and your loved ones. Living with stage 4 cancer requires adapting to a new reality, and maintaining the best possible quality of life. Areas to focus on may include prioritising self-care (mental, emotional, physical, and spiritual), building a support network, and staying informed on the latest research, advancements, and general medical knowledge that are relevant to your cancer. 

Keep open communication with your doctors and loved ones, and seek financial assistance where necessary. Facing stage 4 cancer can be a difficult journey, but with a good support system and healthcare team you can find strength and resilience to face the challenges.