What is the survival rate of stage 4 non-small cell lung adenocarcinoma?

Q. My dad is diagnosed with stage 4 non-small cell lung adenocarcinoma. Kindly suggest treatment options.

Answered by
Dr. Monish De
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Sep 29, 2020 and last reviewed on: Jan 09, 2023

Hello doctor,

I want to get a second opinion on my father's treatment for advanced non-small cell lung adenocarcinoma. I want to ensure he is given the best possibility for the longest survival with good quality of life.

He started suffering headaches and was also bringing up small specks of blood in sputum. He went to his GP, who just put him on antibiotics and thought might be sinus problems he has had for a long time. After a few weeks, with headaches getting worse and nausea and vomiting, he saw another GP, and tests were scheduled. He has had CT scans, PET scans, MRI. There is a lesion in his left lung upper lobe. There is low attenuation (3.5 x 2 cm) in the right frontal lobe anteriorly and a lytic lesion in the left proximal femur. He was a pipe smoker for many years but has now given up. He had no cough and still does not, no wheezing, and oxygen saturation was 97%. ECG was normal, and he was a fit and active 67-year-old, regularly windsurfing and cycling.

He has now been told he has stage 4 cancer, not curable and basically just a case of keeping him going as long as possible. To that end, the currently prescribed treatment are Dexamethasone to relieve pressure in the brain and alleviate headaches, Folic acid, Levomepromazine, Lansoprazole 30 mg for gastro-reflux, and Oral morphine for pain in the head.

He will then start chemotherapy in two weeks. One day every three weeks to be hooked up to a drip for several hours for four to six rounds. I would like to know if this is the best treatment as I would have expected radiotherapy for the brain lesion or had considered trying to get him cyberknife treatment for that. However, the consultant does not seem to be interested in pursuing these options and says there is no point.

We have also not been given any idea of chances of success in keeping cancer at bay, or if it is possible for it to go into remission and survival predictions. Although he was told he should start thinking of where he would like to die - hospital or home. Please help.



Welcome to icliniq.com.

Your father is suffering from non-small cell lung carcinoma stage IV. Disease subtype is adenocarcinoma.

Since it is stage IV, adenocarcinoma and his age are already 67, I would advise you on EGFR (epidermal growth factor receptor) and ALK (anaplastic lymphoma kinase) mutation investigation from his biopsy sample. If this mutation report is positive, if EGFR mutation is positive then oral Tyrosine kinase inhibitor (TKI) tablets that are oral chemotherapy tablet Erlotinib will work for him and palliative some of his sufferings.

If ALK mutation is positive, then an oral chemo tablet called Crizotinib will work. Side effects of oral chemo tablets are only skin rash and diarrhea.

If mutation tests are negative, then injectable chemotherapy called Pemetrexed could be an option, but if mutation tests are positive, then oral TKI chemo tablets are the first option.

Since it is already stage IV and his age is 67 years, intent of treatment is palliation and improving quality of life and not cure. Dexamethasone to relieve pressure on the brain, Morphine for headache and Lansoprazole can be continued. I will also advise radiation to brain lesions, which will help him to improve in quality of life.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Colon Cancer - Causes, Symptoms, Diagnosis, and Treatment

What Is Colorectal Cancer and What Are Its Stages ... Its stages are: Stage 1 - Cancer has spread to the colon or rectal mucosa, but not to the walls of the org   Read full

Should chemotherapy be given after tumor removal for 13.32 U/ml CA-125?

.. went through your reports (attachment removed to protect patient identity), I have a couple of questions. First and foremost, any other blood tests done, called as tumor markers, similar to CA 125, like AFP, bHCG, inhibin, estrogen?   Read full

Could my liver hemangioma actually be liver cancer?

Also had a brain MRI done because I thought I definitely had stage 4 cancer ... The specialist also told me if I had stage   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions.  Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this.  Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades.  Read more»

Ask your health query to a doctor online?

Ask a Medical Oncologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.