Stage 4 is the most severe stage of cancer, with the highest risk of mortality. However, many factors affect a person’s life expectancy.

In this article, we describe what stage 4 cancer is and the survival rates for people with different types of cancer at this stage. We also look into forms of support available for people with cancer and their loved ones.

A black and white image of a person with stage 4 cancer standing with their back turned.Share on Pinterest
Miguel Angel Partido Garcia/Getty Images

Stage 4 cancer is not always terminal. It is usually advanced and requires more aggressive treatment.

Terminal cancer refers to cancer that is not curable and eventually results in death. Some may refer to it as end stage cancer. If a doctor determines that cancer is terminal, this usually means that the cancer is so advanced that treatment options focus on controlling rather than curing the cancer. More severe cancers are more likely to be terminal.

Survival rates convey the likelihood of living for a certain period, such as 5 years, after a doctor diagnoses cancer. The 5-year survival rate for people with breast cancer that has spread to distant areas of the body is 28%, meaning that 28% of people survive for this period.

The same figure for people with prostate cancer that has spread to distant areas is 30%, the American Cancer Society reports.

Survival rates can vary, based on the type of cancer. The 5-year survival rate for mesothelioma that has spread to distant areas is 7%. For distant pancreatic cancer, this rate is 3%.

It is worth noting, however, that these rates are based on large quantities of data obtained in the past. They may not reflect recent advances in treatment and care. Also, a wide range of factors influence each person’s life expectancy.

Determining the severity of cancer and its stage is a complex process. Doctors are still learning about all the factors that affect how cancer develops and affects the body. Predicting life expectancy is very difficult. The doctor will consider many variables, such as the type of cancer, its location, and whether the person has any other underlying health conditions.

Learn more about how doctors determine the stages of cancer.

Doctors usually describe a person’s outlook using the 5-year survival rate. These are calculated based on data from thousands of other people with a similar cancer at a similar stage.

The original location of the cancer determines its type. Survival rates vary, depending on the type of cancer and how far it has spread within the body.

Below, we describe the survival rates for some of the most common forms of cancer in stage 4:

Breast

Breast cancer is one of the most common forms of cancer in the United States. In 2018, there were 254,744 new cases of breast cancer among females in the country.

The American Cancer Society estimate that the 5-year survival rate for people with breast cancer that has spread to distant areas of the body is 28%.

Lung

There are two main types of lung cancer: small cell and non-small cell. Most cases are non-small cell.

According to the American Cancer Society, the average 5-year survival rate for people with non-small cell lung cancer that has spread to distant areas is 6%. For distant small cell lung cancer, the 5-year survival rate is 3%.

However, it is important to note that these figures do not reflect recent advances in treatment.

Colorectal

Colorectal cancer affects the colon or rectal areas and is generally treatable in its early stages. Around 149,500 new cases of colorectal cancer were diagnosed in the U.S. in 2021.

The American Cancer Society reports that the 5-year survival rate for colorectal cancer that has spread to distant areas is 14–16%.

Prostate

Prostate cancer is the most common form of cancer among men in the U.S. The prostate is a small gland in the pelvis. If the cancer spreads to distant areas, the 5-year survival rate is 30%.

The treatment plan for stage 4 cancer depends on the type and how far it has spread. Some treatments aim to improve the person’s quality of life and control their symptoms. Others aim to stop the cancer’s growth.

Treatments at this stage might include:

  • chemotherapy, though the risks may be too high when the cancer has spread extensively
  • radiation therapy, which can shrink tumors and help with symptoms
  • immunotherapy, which helps the body’s immune system fight the cancer
  • surgery to remove tumors
  • targeted therapy, which aims to slow tumor growth

Stage 4 is the most severe stage of cancer. Metastatic cancer is another name for this stage. It conveys that the cancer has metastasized — spread to distant areas of the body.

Cancer is a group of diseases that cause rapid cell growth. Cancerous cells grow and reproduce uncontrollably in a certain area of the body, forming a tumor. As a tumor grows, the cancerous cells can spread to other areas of the body.

Doctors typically use a staging system to determine how severe a case of cancer is. This helps them determine the best course of treatment.

A range of tests can help determine the stage of cancer. They include:

Doctors take other factors into account, too, including:

  • the size of the primary tumor
  • its location
  • whether cancerous cells have entered the lymph nodes
  • how far these cells have spread within the body
  • the type of cancerous cells
  • the person’s overall health

Together, this information helps determine whether cancer is less advanced, at stage 1, very advanced, at stage 4, or somewhere in between.

Cancer can take an enormous emotional and physical toll. In the U.S. and other countries, many sources of support are available for a person with cancer and their family and friends.

Big organizations such as the American Cancer Society provide a wealth of resources, including:

  • information centers
  • residential options during treatment
  • transportation between treatment locations
  • products related to hair loss and mastectomies
  • a range of support groups

They also provide online networks and apps for people with cancer, caregivers, and loved ones.

The National Cancer Institute has a database of more than 100 organizations that offer emotional, financial, and practical support.

Learn more about coping with a cancer diagnosis and finding dedicated support here.

Stage 4 is the most severe stage of cancer, but it is not always terminal. Doctors use a wide range of factors to classify cancer’s stage, including the size and locations of tumors and the person’s overall health.

Generally, the likelihood of long-term survival decreases as cancer spreads farther from its point of origin. But many personal factors can affect a person’s outlook. While survival rates are a guide, a person’s medical team can provide a clearer picture of the overall outlook.