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How do stage 4 NSCLC patients given 12 months survive 5 years?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am writing about my cousin, who was diagnosed with stage 4 non-small cell lung cancer (NSCLC) at age 32. At that time, doctors told the family that survival might be around 12 months. Fast forward, and he has now completed five years and is still alive, on intermittent treatments. We are grateful but confused.

  1. Why did a 32-year-old with stage 4 NSCLC, given 12 months, survive five years?

  2. Does this mean the initial prognosis was wrong or the cancer biology changed?

  3. He had an EGFR mutation and responded well to medications.

  4. Are long survivors becoming more common now, or is this still rare?

Kindly help.

Answered by Dr. Amandeep Singh Arneja

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

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Hello,

Welcome to icliniq.com.

I understand your concern.

What you are seeing in your cousin is actually something we are beginning to see more often now, especially in certain types of lung cancer. When doctors give a survival estimate like 12 months, it is always based on averages from older data and typical disease behavior, not an exact prediction for a person.

In your cousin’s case, the presence of an epidermal growth factor receptor (EGFR) mutation is very important. This type of lung cancer often responds very well to specific targeted tablets, and the disease can remain controlled for a long time.

I have seen a few patients in my own practice who continued doing well for several years on these treatments, much longer than what was initially expected.

So this does not mean the original doctors were wrong. It simply reflects how much treatment has improved and how differently some cancers behave depending on their molecular profile.

In such cases, the disease can be kept under control for years with the right medicines, even though it is technically stage 4. Long-term survival is still not the most common outcome, but it is no longer as rare as it used to be, particularly in patients like your cousin who respond well to treatment.

I hope you are satisfied with my answer.

For further queries, you can consult me at iCliniq.

Thank you.

Medically reviewed by iCliniq medical review team
Published At April 8, 2026
Reviewed At April 8, 2026

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Amandeep Singh Arneja
Dr. Amandeep Singh Arneja

Pulmonology (Asthma Doctors)

Education:

MD RESPIRATORY MEDICINE

Professional Bio:

I am Dr. Amandeep Singh Arneja, a dedicated Chest Physician and Senior Resident in Pulmonary Medicine at Jawaharlal Nehru Medical College (JNMC), Wardha, with extensive training in the management of complex respiratory and critical care conditions. I completed my M.B.B.S. from Universal College of Medical Sciences, Tribhuvan University (2016) and M.D. in Respiratory Medicine from Shri Shankaracharya Institute of Medical Sciences, Bhilai (2025), where I gained hands-on expertise in managing ICU patients, performing advanced diagnostic and therapeutic procedures, and conducting research in pulmonary diseases. My areas of expertise include: Management of asthma, COPD, tuberculosis, and interstitial lung disease Critical care management (ICU care, mechanical ventilation) Pulmonary function testing (spirometry, DLCO) Interventional procedures (thoracentesis, ICD insertion, bronchoscopy) Sleep medicine and polysomnography Research, academic writing, and clinical presentations I hold certifications in Good Clinical Practice and Biomedical Research. I am a proud member of the National College of Chest Physicians (NCCP). Alongside my pulmonary expertise, I have also completed a CPCDM Fellowship in Diabetes from RSSDI, enabling me to provide holistic care for patients with respiratory diseases complicated by diabetes. Currently, I am also pursuing a Fellowship in Critical Care Medicine, which further enhances my ability to manage critically ill patients with respiratory and systemic illnesses. With multiple research publications, conference presentations (NAPCON, SSIMSCON), and a strong academic background, I strive to combine evidence-based medicine with compassionate patient care. My mission is to provide comprehensive, high-quality care to patients suffering from respiratory and lifestyle-related diseases.

This doctor is not available for online consultations on the platform anymore.

Consult other doctors in the same speciality
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