The most advanced form of non small-cell lung carcinoma is stage four lung cancer. This stage is not considered curable, and doctors focus on treating the symptoms of the disease to improve quality of life. Although NSCLC typically presents symptoms early on, up to 40 percent of patients are diagnosed with stage four NSCLC.
What it Means
The TNM system expresses the size of the tumor (T), whether it has metastasized (M) and if the lymph nodes (N) are involved. In stage 4, the tumor can be any size, has definitely metastasized and may involve the lymph nodes. There are various degrees of involvement. Since tumors can be any size, stage 4 can be assigned T0, or T1-4. T3 and 4 indicate the growth has invaded other structures such as the esophagus, pleural space or heart.
N0 means no lymph node involvement, so in advanced stages of NSCLC this number will be 1-3. A ‘1’ means it involves the nodes on the same side of the body it began. A ‘2’ indicates distant node involvement still on the same side. A ‘3’ means the malignant cells are affecting the opposite side of the chest and above the collarbone.
M0 means no metastasis, so M1 will always be the minimum assignment for an advanced cancer case. Cancers are considered inoperable when they have migrated to other regions of the body.
NSCLC is Symptomatic
Even early on, this disease usually presents symptoms. As it progresses they get worse and new issues are likely to develop. Problems that present include bloody cough, also called hemoptysis and dysphonia causing hoarseness in the voice. Other symptoms include chest pain and Pancoast’s syndrome, which causes pain down the arm. Finally, fluid build-up in the lungs can cause pneumonia.
While physical pain and discomfort can be addressed with palliative treatments, emotional distress is also a concern. Support groups help patients with stage 4 cancer find hope to live. Patients are encouraged to cherish family time or time with loved ones, and to have hope for the futures of their children or grandchildren. Support is available by phone, in person or through internet multimedia.