What is the Average Life Expectancy?
"Stage four" or "metastatic" cancer means the cancer has spread from its original location to distant parts of the body. While this is the most advanced stage, it's crucial to understand that "life expectancy" is not a single number but a statistical average that varies significantly. Survival rates are often discussed in terms of a "5-year relative survival rate," which is the percentage of people who are still alive five years after diagnosis compared to the general population. This interactive chart shows these rates for some common cancers that have spread to a distant stage.
Data Source: American Cancer Society, based on SEER program data for distant-stage cancers diagnosed between 2013 and 2019.
What Factors Influence Life Expectancy?
A prognosis is highly individual and depends on many interconnected factors. Statistics provide a general picture, but a person's specific situation is unique. Doctors consider a wide range of variables to estimate a prognosis and create a treatment plan. Below are some of the most significant factors that influence the outlook for a person with stage four cancer. Click on each card to learn more.
How is a Cancer Prognosis Determined?
Determining a prognosis is a careful, multi-step process that combines information from various tests and assessments. It's an ongoing evaluation that can change as more information becomes available or as the cancer responds to treatment. This process helps the medical team understand the cancer's characteristics and tailor the most effective treatment plan for the individual. Here is a simplified overview of the key steps involved.
Diagnosis and Staging
The process begins with confirming the cancer diagnosis through biopsies and imaging tests (like CT, MRI, PET scans). These tests determine the primary site of the cancer, its type (e.g., adenocarcinoma, squamous cell carcinoma), and confirm that it has spread to distant sites, which defines it as stage four.
Molecular and Genetic Testing
A sample of the tumor is tested for specific genetic mutations, proteins, and other biomarkers. This is crucial for identifying targets for modern therapies like targeted therapy and immunotherapy, which can dramatically improve prognosis for some patients.
Patient Health Assessment
Doctors evaluate the patient's overall health, including age, fitness level (performance status), and any other existing medical conditions (comorbidities). A patient's ability to tolerate aggressive treatments is a key factor in their prognosis.
Synthesis and Consultation
An oncology team reviews all this information. They compare the patient's specific case to data from clinical trials and population studies to formulate a prognosis. This is communicated to the patient as a range of possibilities, not a definite timeline, and is used to guide treatment decisions.
What Are the Treatment Options?
The goal of treating stage four cancer is often not to cure the disease, but to control it, extend life, and maintain the best possible quality of life. Treatment is systemic, meaning it travels through the bloodstream to reach cancer cells throughout the body. The specific plan is highly personalized based on the cancer type, its genetic markers, and the patient's health.
Systemic Therapies
These are the primary treatments for metastatic cancer.
- Chemotherapy: Uses drugs to kill fast-growing cells. It's often used when targeted therapies aren't an option.
- Targeted Therapy: Drugs that specifically attack cancer cells with certain genetic mutations, often with fewer side effects on healthy cells.
- Immunotherapy: Boosts the body's own immune system to recognize and fight cancer cells.
- Hormone Therapy: Used for cancers that are fueled by hormones, such as certain breast and prostate cancers.
Local Therapies and Palliative Care
These treatments target specific tumor sites to relieve symptoms and improve comfort.
- Radiation Therapy: Uses high-energy rays to shrink tumors, which can relieve pain or pressure caused by a tumor on a nerve or bone.
- Surgery: In some cases, surgery may be used to remove a metastasis that is causing a specific problem, such as a blockage in the digestive tract.
- Palliative Care: A specialized field of medicine focused on providing relief from the symptoms and stress of a serious illness. It is not the same as hospice and can be provided alongside curative treatment to improve quality of life at any stage.
How Can a Person Improve Their Quality of Life?
Living with stage four cancer involves managing both the disease and its treatment while focusing on well-being. Improving quality of life is a central goal of care. It involves addressing physical symptoms, emotional and mental health, and social support systems. Many strategies can help individuals feel better and live more fully, even during treatment.