Lung Cancer FAQ: Chemotherapy for stage IV lung cancer

Q: "I have stage IV lung cancer. Why is chemotherapy sometimes used to treat later stage (Stage IV) lung cancer? What would happen if I did not take chemotherapy?"

A: Chemotherapy for stage IV lung cancer is used to slow the growth of the tumor(s), improve symptoms, provide a better quality of life and prolong life for as long as possible.

If you decide to take chemotherapy there is a good chance that these goals will be met for you. You may see shrinkage of the cancer, leading to relief of symptoms and an improved quality of life. By controlling the growth of the cancer, you may prolong your life as well.

Side effects of chemotherapy are usually temporary and are usually well controlled by modern medications. Side effects of treatment are generally less severe than symptoms from untreated cancer, and patients who receive chemotherapy report that their quality of life is better than those treated with supportive care alone.

If you have significant side effects from chemotherapy your doctor will likely recommend stopping treatment or switching to alternate chemotherapy drugs.

If you chose not to have chemotherapy, you would be given supportive care to help reduce symptoms caused by the cancer as much as possible. The focus would be on giving you the most comfortable quality of life as opposed to slowing down the cancer.

You could be offered radiation to reduce shortness of breath, cough or chest pain/pressure. Radiation for this purpose is usually tolerated well. You would also be offered pain medication and other medication to reduce symptoms. You would still receive support and care from your oncologist and/or primary care physician. Healthcare providers like nurses and social workers would also be available to help you. 

Hospice care is of great benefit to patients who choose not to have chemotherapy or are too ill to have it. You should be able to receive most care in your home. You would not be left without care or support.

The decision to have chemotherapy or not is yours, and that decision will be respected by your physician and other health care team members. It is always best to find out the benefits and drawbacks of each treatment you are offered so that you can make an informed decision you will be satisfied with.

Answers provided by Providence lung cancer experts.

Last updated: August 2002