Stage 4 is the most severe stage of cancer, with the highest risk of mortality. However, many factors affect stage 4 cancer survival rates, including the type of cancer.

This article describes what stage 4 cancer is and the survival rates for people with different types of cancer at this stage. It also looks into forms of support available for people with cancer and their loved ones.

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.


Stage 4 cancer develops when cancer cells break away from the primary cancer and spread to other parts of the body via the bloodstream or lymphatic system.

The National Cancer Institute states that when cancer cells spread, they first do so by growing into or invading nearby healthy tissue.

They then move through the walls of the nearby blood vessels or lymph nodes and travel through the bloodstream or lymphatic system.

The cancer cells will then stop in the small blood vessels at a distant location and attach themselves to the surrounding tissue. The cancer will grow, forming small tumors.

New blood vessels will grow, providing a blood supply that allows the cancer to continue to spread.

A person may not experience any symptoms of stage 4 cancer. However, if symptoms are present, they can differ depending on where the cancer has spread. For example:

  • Spread to the bone: A person may experience fractures and bone pain.
  • Spread to the brain: Dizziness, seizures, and headaches can develop.
  • Spread to the lung: A person may develop shortness of breath.
  • Spread to the liver: Cancer that has spread to the liver can cause abdominal swelling or jaundice.
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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.

Learn more about how doctors determine the stages of cancer.

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.

Doctors usually describe a person’s outlook using the 5-year relative survival rate. Relative survival rates convey the likelihood of living for a certain period of time after a doctor diagnoses cancer compared to others without the condition.

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. Relative survival rates vary depending on the type of cancer and how far it has spread within the body.

Below are the relative survival rates for some of the five most common forms of cancer in stage 4. It is important to note that these figures may not reflect recent advances in treatment.

Cancer type5-year relative survival rate

Learn more about the most common types of cancer and their overall survival rates.

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, very advanced, or somewhere in between.

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, which aims to kill cancer cells
  • 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

Palliative care aims to improve a person’s quality of life. It can help people and their caregivers manage the symptoms of the cancer and the side effects of the treatment, such as pain and stress.

Although it does not treat cancer, it can provide help with a person’s mental, emotional, and physical health. It can also help with a person’s social and spiritual needs.

Palliative care can be appropriate at any time after someone receives a cancer diagnosis.

Learn more about palliative care and whether a person may find it beneficial.

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 information and resources 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.