Guide Stage 4 Cancer Treatment India

Stage 4 Cancer Survival Rates​

The 4th and final stage of cancer is the most dangerous one and is referred to as metastatic cancer, which means the cancer has spread to other organs or tissues. Thus, survival rates of stage 4 cancer are very diverse due to the type of cancer, general health, and available treatments. The five-year survival rate is one of the prevailing coefficients that can be used to assess the prognosis.

Here are approximate 5-year survival rates of some stage 4 cancers:

Breast cancer: ~22–30%
Lung cancer (NSCLC): ~7–10%
Lung cancer (SCLC): ~3%
Colorectal cancer: ~15%
Prostate cancer: ~32%
Pancreatic cancer: ~3%
Liver cancer: ~3–11%
Ovarian cancer: ~17–30%
Stomach cancer: ~6%
Brain cancer (glioblastoma): ~6%

Advanced Cancer Treatment Options​

According to the type and stage of cancer, genetic factors, and general conditions of the patient, there are different options of the cancer treatment. Below are some of the newest and most efficient therapies that have been used in the treatment of stage 4 or metastatic cancer includes:

Targeted Therapy

Its mechanism: Acts on certain target nucleic acids or proteins that enable growth of cancer cells.
Examples:

• HER2 inhibitors (e.g., Trastuzumab for breast cancer)
• EGFR inhibitors (e.g., Osimertinib for lung cancer)
• BRAF inhibitors (e.g., Dabrafenib for melanoma)

Immunotherapy

The process mechanism of the treatment: strengthens the body’s immunity where the immune system fights against cancer.

Examples:

• Checkpoint inhibitors (e.g., Pembrolizumab, Nivolumab)
• CAR-T cell therapy (for blood cancers like leukemia and lymphoma)
• Cancer vaccines (e.g., Sipuleucel-T for prostate cancer)

Personalized Medicine is Genomic Testing and Personalized Therapy.

Biomarker Care: This procedure involves analysing the tumor’s DNA to determine the best treatment to apply.

Examples:

• FoundationOne CDx test (for solid tumors)
• Liquid biopsy (finding a blood biomarkers that may indicate cancer)

Advanced Chemotherapy

How it works: Employ utilization of drugs that have fewer side effects or that are in some way administered in targeted ways.

Examples:

• Antibody-drug conjugates (e.g., Trastuzumab emtansine)
• Metronomic chemotherapy (low-dose continuous treatment)

Radiation Therapy Innovations

How it works: The ablation of tumors using high accuracy radiation that has the least chances of affecting the surrounding tissues of a human body.

Examples:

Proton therapy (more precise than traditional radiation)
Stereotactic Body Radiation Therapy (SBRT) for lung and liver cancer

Tumor Ablation Techniques

How it works: Like in many cases of cancer treatment it has a direct impact on tumors without even requiring surgery.

Examples:

• Radiofrequency ablation (RFA)
• Cryoablation (freezing tumors)

Hormone Therapy

It works by blocking hormones that feed specific types of cancer.

Examples:

• Androgen deprivation therapy (ADT) for prostate cancer
• Aromatase inhibitors (e.g., Letrozole for breast cancer)

Palliative Care for Stage 4 Cancer​

Palliative care can enhance the quality of life of the patients with advanced cancer by addressing both the medical illness and physical and psychosocial distress. It may be rendered concurrently with the curing treatments or the terminal care.

Pain and Symptom Management

• Pain relief: Opioids (morphine, fentanyl), NSAIDs, nerve blocks
• Vomiting & nausea: Antinauseants (OND, MET)
• Fatigue: Corticosteroids, blood transfusions, lifestyle modifications
• Breathing difficulties: Oxygen therapy, bronchodilators, fluid drainage
• Loss of appetite & weight loss: Nutritional therapy, appetite stimulants
• Depression & anxiety: Counselling, antidepressants, relaxation techniques

Emotional & Psychological Support

• Remedial Service: Aimed at getting medical assistance from support groups, one on one counselling.
• Meditation, Yoga & Pranayam: The wellness benefits of Meditation & Yoga & Pranayam a type of breathing exercise.
• Spiritual Support: Guidance from chaplains, priests, or religious advisors

Care at Home or Hospice

• Self-care: The nurses & caregivers offered care to the patients at home.
• Hospice care: Focuses on comfort and dignity in the final stages
• Respite care: Temporary relief for family caregivers

Support for Families & Caregivers

• Counselling & grief support
• Practical help (legal, financial, funeral planning)
• Training for home caregiving

Stage 4 Cancer Prognosis​

The fourth and the last stage are called metastatic and this indicates that the cancer has spread to the distant organs. The survival rate of the disease is largely determined by the stage, reaction to treatment, and the general health of the individual suffering from the disease.

Key Prognostic Factors

• Partition by Cancer – Certain cancers are more curable than the others like prostate and thyroid than pancreatic and lung cancers.
• Site – This factor involves the number of organs that have been affected thus; the higher the affected organs, the higher the chances of survival.
• Treatment response – immunotherapy, targeted therapy and precision medicine to manage cancers and the trend of the five-year survival rate has shifted.
• Overall Health & Age – It’s advisable to give treatments to young and healthy patients rather than old patients who might also be experiencing other health complications.

Immunotherapy for Advanced Cancer​

Immunotherapy is one of the advanced therapies that assist the immune system to fight cancerous cells. It is particularly useful in the last-stage cancers or, more precisely, stage 4 ones and has resulted in complete cures for some individuals.

Types of Immunotherapy

Checkpoint Inhibitors

Functioning: Assists the body to distinguish cancer cells and target them as usual invaders.

Common drugs:

• PD-1 inhibitors: Pembrolizumab (Keytruda), Nivolumab (Opdivo)
• PD-L1 inhibitors: Atezolizumab, Durvalumab
• CTLA-4 inhibitors: Ipilimumab (Yervoy)
• It is utilized in: Lung cancer; melanoma; renal cancer; bladder cancer; colorectal cancer; head and neck cancer

CAR-T Cell Therapy

How it works: Alterations of the T-cells to cancer targeting cells.

• Common drugs: Tisagenlecleucel (Kymriah), Axicabtagene ciloleucel (Yescarta)
• Applicable for: Leukemia, Lymphoma, Multiple myeloma

Cancer Vaccines

Process: Educates the immune system regarding cancer.

Examples:

• Provenge (Sipuleucel-T) – for prostate cancer
• mRNA vaccines (in development for various cancers)
• For: Prostate tumor/ cancer, melanoma, trials for lung/breast tumors

Monoclonal Antibodies

How it works: Interference with specific cancer proteins and elicits an immune response by the body.

Examples:

• Rituximab (for lymphoma), Trastuzumab (for HER2+ breast cancer)

Cytokine Therapy

How it works: Deploys elements such as interferons and interleukins to improve the body’s ability to fight disease.

Examples:

• Interleukin-2 (IL-2), Interferon-alpha

Used for: Melanoma, kidney cancer

Targeted Therapy for Stage 4 Cancer​

Targeted therapy is one of the specialized programs in cancer which is personalized to hormone receptors, enzymes, or proteins that aid the development of cancer cells. It is more selective than chemotherapy and usually has fewer side effects.

How Targeted Therapy Works

• The cell’s individual characteristics, mutations or particular markers in cancer cells
• Fights cancer without harming the normal cells of the human body.
• This drug is administered orally or through intravenous administration.

Chemotherapy for metastatic Cancer​

Chemotherapy (chemo) is one of the widely used therapies for metastatic cancer, whereby the doctor uses chemicals to destroy or slow down the growth of cancer cells. It is capable of reducing tumour size, halting malignant growths, and reduce symptoms and suffering; they are usually not for curing stage four cancer.

How Chemotherapy Works

• Systemic Treatment – A treatment that aims to reach the cancer cells all over the body with the help of the bloodstream.
• Kills Fast-Growing Cells – This tends to affect cancer cells but also has an impact on other cells within the body that divides fast such as hair, blood, and the lining of the gut.
• Can Be Combined – Immunotherapy, Targeted therapy, or Radiation can be combined with it.

Radiation Therapy for Advanced Cancer​

Radiation therapy is the process of using advanced beams of X-rays, protons or electrons to kill cancer cells or to reduce size of tumor. This medication is commonly administered to the patient with advanced cancer in order to reduce the pain and sometimes also prolongs his/her life.

Types of Radiation Therapy

External Beam Radiation Therapy (EBRT)

• Where it is used: A machine is used to point radiation at the tumor from outside the body.
• Applicable to: Brain, bone, lung, liver, female breast and prostate malignancies.

Advanced types:

• Intense-Modulated Radiation Therapy, abbreviated IMRT – aimed at precise targeting of tumors.
• Stereotactic Body Radiation Therapy (SBRT) – High-intensity efficacy and localized radiation therapy
• Proton Therapy – Less harm to the adjacent tissues

Internal Radiation Therapy (Brachytherapy)

• How it works: Small pieces of radioactive material that may be planted in the human body, close to tumor.
• Used for: Prostate, cervical, uterine, and some head/neck malignancies.

Systemic Radiation Therapy

• How it works: There is administration of radioactive drugs (radiopharmaceutical agents) which circulate in the blood stream.

Examples:

• Radium-223 (Xofigo) – For bone metastases in prostate cancer
• Iodine-131 – For thyroid cancer

Alternative Treatments for Stage 4 Cancer​

Stage IV cancer cannot be cured with other treatments, but it cannot be ruled out that making use of natural remedies can complement other medical treatments like chemotherapy, immunotherapy, or radiation, alleviate symptoms, and enhance one’s quality of life. There are some that have gone through rigorous research to be prescribed together with conventional medicine (integrative oncology).

Mind-Body Therapies

These approaches assist in minimizing stress, pain, and management of one’s emotional health.

• Self -Exploration – Helps in introspection and understanding oneself
• Yoga & Tai Chi – gone up and down specialized exercises that increase pliability, decrease pain, and improve disposition.
• Music Therapy – Helps to reduce pain and other emotional issues
• Art Therapy – Reduces effect of fear, anxiety, and depression.

Herbal & Natural Remedies

There are medicinal plants that are widely believed to have immune boosting value and fewer side effects but they should not be taken whilst on cancer treatment.

• Turmeric (Curcumin)– an anti-inflammatory and that may help to halt cancer development.
• Green tea (EGCG) – helps to have antioxidants and anticancer properties.
• Ashwagandha – Helps with stress, fatigue, and immune support
• Reishi, Turkey Tail and Cordyceps Extracts – It increases immunity

Dietary & Nutritional Support    

A healthy diet helps in the improvement of the energy levels and also the immune system.

• Anti-Inflammatory Diet – A diet that lack in processed foods, red meat, sugar, and saturated fats is recommended as this incorporates a number fruits, vegetables, whole grain, nuts and seeds.
• Healthy Fats – Olive oil, avocados, omega-3s from flaxseeds & walnuts
• Low-sugar diet –Reducing sugar may have an impact on cancer-related fatigue
• Juice & Smoothies – Is useful in the case of loss of appetite.

Acupuncture & Traditional Medicine

• Acupuncture – Helps with pain, nausea (from chemo), and fatigue
• Ayurvedic Medicine & Traditional Chinese Medicine (TCM) this comprises of herbs and supplements, elimination of toxins from the body and restoring the body energy of a person.
• Homeopathy – Some of them report its use for this purpose, however, evidence of effectiveness remains inconclusive.

Hyperthermia & Oxygen Therapy (Experimental)

• Hyperthermia Therapy – uses thermal treatment to kill cancer cells though the process is still under research.
• Oxygen Therapy has three techniques; Ozone, Hyperbaric Oxygen, and there is minimal evidence to support its use but may augment oxygenation.

Emotional & Spiritual Support

• Counselling & Support Groups – Makes it possible to feel less anxious and accept the situation
• Energy Healing (Reiki, Pranic Healing) – Some consider it to be soothing and reduces pain.
• Prayer and other spiritual practices – May help to have a source of hope

Nutritional Support in Advanced Cancer​

Optimal nutrition is an important part of controlling symptoms, maintaining strength, and improving quality of life for patients with advanced cancer. As cancer and cancer treatments may result in weight loss, fatigue, and changes in appetite, individualized nutrition may prevent weight loss and muscle wasting and support immune function.

Principal Objectives of Nutrition in Advanced Cancer

• Ensure healthy weight – Avoid excessive weight loss or muscle wasting
• Optimize immune function – Minimize risk of infection
• Improve energy levels – Fight weakness and fatigue
• Decrease side effects of treatment – Lessen nausea, constipation, and mouth sores
• Improve quality of life – Enhance overall well-being

Pain Management in Stage 4 Cancer​

Pain is also a frequent symptom in stage 4 cancer but can be successfully treated with medication, therapy, and supportive care. The best strategy varies depending on the reason, severity, and location of pain (nerve pain, bone pain, organ pain, or treatment-induced pain).

Interventional Pain Management

• Nerve Blocks – Pain-numbing injections into painful nerves.
• Epidural or Spinal Injections – To treat severe back pain or bone metastases.
• Radiation Therapy – Reduces the size of tumors and pain from metastatic cancer (e.g., bone metastases).

Alternative Therapies (Complementary Care)

• Acupuncture – Reduces cancer pain and nerve pain.
• Massage & Physical Therapy – Relieves muscle pain and stiffness.
• Relaxation Techniques (Meditation, Deep Breathing, Yoga) – Reduces stress-induced pain.

Hospice Care Options for Late-Stage Cancer​

• Palliative Care – More concerned with pain management & quality of life, offered at any point during cancer.
• Hospice Care – For final stages of care, maintaining dignity and comfort.
• Home Pain Relief – Encompasses medications, home care, and supportive treatments.

Survivor Stories of Stage 4 Cancer

Mrs. Maria Okosodo from Nigeria

Condition: Stage 4 Appendix Cancer

Treatment: Laparotomy for Tumor Removal followed by Chemotherapy

Hospital: Fortis Hospital, Shalimar Bagh, Delhi, India

Oncologist: Dr. Kapil Kumar

Mrs. Maria Okosodo, a 54-year-old Nigerian woman, suffered from long-standing indigestion that went undiagnosed back home. Determined to receive better medical treatment, she flew to India with the help of GetWellGo. With the expert care of Dr. Kapil Kumar at Fortis Hospital, thorough diagnostic tests confirmed that she had stage 4 appendix cancer. Maria went through a long 8-hour surgery, and 95% of the tumor was successfully removed, along with subsequent chemotherapy sessions. Despite the obstacles brought by the COVID-19 pandemic, she continued adhering to her treatment and check-up schedules. Now, Maria is living a healthy and wholesome life in Nigeria again.