Why is surgery never offered to Stage 4 lung cancer patients?

I too have wondered this. Plus when like me you respond to immunotherapy and tumour are shrinking why don't they continue to try and cure? Instead I'm told yes it's responding well but this is only palliative.... seems so unfair some of mine have now become barely visible

Hi Harebelle

i like you have stage 4 Adenocarcinoma NSCLC lung cancer with spread to the bones and I’m 58, and I’ve wondered why I wasn’t surgery wasn’t offended, I tried asking my specialist but what’s said don’t make sense. I also wonder if it’s a funding thing, I have responded well to the chemotherapy and immunotherapy and there has been improvement and the tumour had shrunk, when I asked what size tumour is operable I’m just told it’s not possible for stage 4 but never why. I really wish someone could answer this question

Hi all, I can only say that in my case they believed surgery was an option at first, but due to Covid getting in the way and me getting lost in the system for a couple of months, my cancer had in that time metastasised to my chest lymph nodes making it impossible to operate. I was then offered immunotherapy.

Exactly.

Apparently lung cancer thats metastised to bones can, with careful monitoring, be treated as a chronic condition, so surely it makes sense to cut out the primary and maybe do ablation to the little hot spots in the other lung? Hit it with everything they've got,

Other types of cancer at stage 4 can often times live 10 years and beyond.

But wirh stage 4 lung cancer it's rare ro last more than 5 years.

Maybe the extremely narrow range of treatment options play  a part?  Who knows

I'd  love to know what's really going on.

Hi Harebellle , interesting questions , I’m stage 3 and was told I couldn’t have surgery because of two lymph nodes being activated and too much risk of the surgery causing a spread … I’m guessing that you put this question to your consultant ? What do they have to say? …. I often wonder  if it’s because in the case of other cancers that metastasis to lungs etc it’s because they are dealing with a breast cancer in the lung or a bowel cancer in the lung and not a primary lung cancer ? I don’t honestly know but I don’t want  to believe that lung cancer is not treated with it’s very best option regardless of stage / financial consideration  it’s too heartbreaking to consider…  

You are right Elly. If it’s a primary cancer with no lymph node involvement and depending it it’s accessible, then I think surgery is the first line treatment.

I was gutted when they said the lymph nodes were activated …. And then EBUS said yes cancer cells there too …. It was a really close call if they would still choose surgery and they debated it in the MDT but in the end the thoracic consultant advised too risky ….  I don’t doubt that it if they could’ve they would’ve though …. X

I havent asked  my Oncologist. Maybe I should?

I don't get the 'not operating if there's lymph nodes involvement"

Other cancers, they whip the llymph nodes out.

In the States they've discovered that chemo plus surgery greatly improves the prognosis for Stage 4 lung cancer.

Found the link 

www.webmd.com/.../do-too-many-lung-cancer-patients-miss-out-on-surgery

"...patients treated with both chemotherapy and surgery saw survival rates approaching 41 months. Those who underwent chemo, radiation and surgery saw survival in excess of 33 months, while surgery alone resulted in a nearly 29-month survival. Radiation plus surgery led to a survival rate approaching 19 months, the study found...."

Interesting!