If you have been diagnosed with lung cancer, the first two questions you may have is how long you are likely to live and whether you will be able to tolerate treatment. In some cases, the cancer may be advanced and the treatment so impactful that it may compromise the quality of your life in a way that you find acceptable—so much so that you consider moving forward without lung cancer treatment.
If you decide to forego it, you will want to know "what's next" so that you can make plans for yourself and your loved ones. Although your healthcare provider can give you some idea of how the disease is likely to progress, each case is different and the answers you seek may not always be so straightforward.
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How Long Do I Have to Live?
It's a reasonable question but one that oncologists are generally hard-pressed to answer, particularly in the earlier stages of the disease. Even though the stage and grade of your cancer can help healthcare providers predict the likely outcome (known as the prognosis), there are few healthcare providers who will give you a precise amount of time because, in all fairness, the "likely outcome" may not be your outcome.
Among the factors that can predict survival times in people with lung cancer:
- Cancer stage, classified by the characteristics of the tumor, whether lymph nodes are involved, and whether the cancer has spread (metastasized)
- Cancer grade, which describes the characteristics of the cancer cell, whether it is likely to spread, and how fast
- Your age, particularly if you are in your senior years
- Your current health, including your general health, wellness, and the chronic illnesses you have
- Your performance status, a term that describes your ability to carry on ordinary daily activities while living with cancer
The one factor that almost invariably affects survival time is whether you seek treatment or not. Even among senior patients with advanced cancer, some form of chemotherapy has been shown to increase survival times significantly.
If caught early enough, lung cancer may even be fully curable. If you are older and present with metastatic lung cancer, you can be still be treated and increase your chance of living at least one year by no less than 40%.
But, for some people, survival is not their primary goal, particularly if they already have poor performance status. If advanced cancer is involved, their ability to tolerate chemotherapy may be poor. If this is you, it is fair and reasonable to ask how long you have to live if you do not opt to seek treatment.
Given that around 80% of all lung cancer cases are diagnosed when the disease is advanced (stage 3 or stage 4), this is a concern and decision point that many people share.
If left untreated, people with non-small cell lung cancer, the most common form of the disease, might live anywhere five to 12 months, depending on the stage. In contrast, people with small cell lung cancer generally survive three to 15 months without treatment (based on the stage).
Tips for Improving Lung Cancer Survival
Survival Benefits vs. Quality of Life
Sometimes the survival benefits of cancer treatment may be small. For example, if a healthcare provider feels that a particular chemotherapyregimen can extend your life by a few weeks but may cause potentially debilitating side effects, you may decide that the consequences of treatment outweigh the benefits. And that's a perfectly reasonable and fair choice.
But it is also important to understand that there are many myths about lung cancer that may be skewing your perspective. One is that people reach a certain age when they are "too old" for lung cancer treatment. In actuality,older people often do well with treatments, particularly newer immunotherapy drugs called checkpoint inhibitors that may be more tolerable than traditional chemotherapy drugs.
Similarly, targeted therapies, which directly target cancer cells and leave normal cells untouched, generally have milder effects than some chemotherapy drugs.
It is also important to acknowledge that chemotherapy regimens used today are nowhere near as problematic as those of the past. For example, they cause less treatment-induced nausea, vomiting, and fatigue.
Lung Cancer Treatment Options
Other Reasons Some Forego Treatment
There are many reasons why people may decide not to pursue lung cancer treatment. Beyond your quality of life or fear of treatment side effects, other issues may influence this decision—whether you are immediately aware of them or not.
Religious Beliefs
Some people choose to pass on cancer treatment due to religious beliefs. These include people who are Christian Scientists, Jehovah's Witnesses, Amish, or Scientologists. For them, their faith and belief will often direct what is the "right" thing to do.
On the other hand, some people may turn to religion for curative purposes, believing that prayer or other practices can rid them of their cancer. There is little if any evidence of this ever working.
While faith is important in dealing with any disease (and can make a difference in how well you cope with the disease), it is important to keep an open mind about the benefits and risks of cancer treatment if your faith does not bar medical interventions.
If in doubt or crisis, speak with a spiritual advisor of your faith, such as pastor or rabbi, to work through any fears or struggles you are experiencing. Doing so can help you make a more informed decision.
Coping and Living Well With Lung Cancer
Financial Concerns
People sometimes choose to forego treatment for financial reasons. They may not want to drain what limited savings they have and that their family depends on. Or, they may lack insurance or think that certain treatments are unattainable to them because they either make too little or too much money.
There are resources for those who are uninsured or underinsured, as well as financial assistance programs that aid in the cost of treatment, transport, home care, family services, and other common concerns.
Before avoiding treatment you think you cannot afford, speak with a social worker at your cancer treatment center who can help you navigate the services and programs available to you.
These may include:
- Medicaid: Available to those with low income as well as people with excessive medical expenses who are medically needy
- Social Security benefits: Available to those with limited income to help pay for medical care and enroll in Medicare if needed
- 2-1-1 services: Provides referrals to medical providers, mental health resources, transportation, food banks, financial assistance programs, health insurance, childcare, and other services (available in most states)
- Hospital care assistance programs: Mandated by federal and state law to provide low-income or uninsured people with free or low-cost medical care
- American Cancer Society: Offers programs that help individuals and families navigate treatment decisionsand emotional challenges
- CancerCare: A national non-profit that offers free support, information, and financial assistance to people with cancer
- Patient Advocate Foundation: A national non-profit that can direct you to financial assistance programs and also offers copay assistance to those who meet eligibility criteria
- Patient Assistance Programs (PAPs): Offered by many pharmaceutical manufacturers to help pay for medications or cover copay costs
Do not decide against cancer treatment for financial reasons without first meeting with a social worker experienced in cancer or a patient navigator offered by many hospitals and cancer treatment centers.
What Is Cancer Insurance?
Lung Cancer Stigma
Some people decide against treatment because of the stigma of lung cancer. For current or former smokers, "smoker's guilt" can get the best of them and lead one to believe that they somehow "deserve" the disease because they made a conscious choice to light up.
Nobody deserves cancer, and lung cancer occurs in smokers and non-smokers alike. As with any potentially life-threatening disease, lung cancer is treated with care and compassion regardless of its possible causes.
If you have problems coping with your diagnosis, ask your healthcare provider for a referral to a psychiatrist or psychologist who can help. Support groups are also available to put you in touch with others who understand what you are going through firsthand.
Making Your Decision
If you are thinking about foregoing cancer treatment, you need to ensure that you make an informed choice based on a full and complete understanding of your illness and possible outcomes. Moreover, the information must be provided in a language you understand without undue influence or coercion.
Understanding cancer can be difficult. Sometimes there is miscommunication. Medical terms may be hard to understand, and treatments can get easily confused and muddled.
If you are struggling to make a decision about whether or not to continue on without lung cancer treatment, there are four things you should do:
- Always take your time and avoid rushing to judgment.
- Seek a second, third, or even fourth opinion if needed—whatever it takes to help you reach a decision you're as confident in as possible.
- Ask as many questions as you need. Do not allow providers to dismiss or minimize your concerns. Be your own advocate or find a patient advocate.
- Work not only with your healthcare provider but with therapists and counselors who can help you work through emotional concerns.
You are ultimately in control of your own medical decisions. Try to walk this road by keeping an open mind, taking the time to listen and educate yourself before closing the door on treatment. If you do decide to skip treatment, it can be helpful to clarify why not only to your loved ones and healthcare provider but to yourself. Own your decision. But remember, too, that you can change your mind.
If a Loved One Declines Treatment
If a loved one decides to forego lung cancer treatment, it can be a difficult, heart-wrenching thing to hear. You may not be able to fully comprehend it at first. In such instances, let your loved one know that you hear them and love them, but that you need a day or two to process the news.
If you do decide you need more information, ask compassionately. Avoid judgmental questions starting with "why," and give your loved one time to express themselves fully without interruption or displays of panic or disapproval.
In the end, there will come a time when you need to respect your loved one's decision, however hard that may be. Acceptance will ultimately make you a better caregiver and prepare you emotionally for when your loved one is no longer with you.
How to Cope With Anticipatory Grief
A Word From Verywell
There are four approaches to medical treatment: preventative, curative, management, and palliative. It is important to remember this when diagnosed with lung cancer. Just because you decide not to undergo chemotherapy does not mean that there are no options available to you.
Even if your lung cancer is not curable, you can still benefit greatly from palliative treatments that can reduce pain and symptoms as the cancer progresses. This not only helps maintain the quality of your life but may, in some cases, extend survival time without undue suffering or stress—particularly when started earlier.
FAQs
Why would lung cancer not be treated? ›
Inoperable lung cancer is a tumor that surgery can't treat. This might be because the cancer is in a hard-to-reach spot or for other reasons, like if it's spread outside your lungs. It's also called unresectable lung cancer. Just because you can't have surgery doesn't mean you can't do anything about the cancer.
Why do some cancers not respond to treatment? ›Resistance can occur when cancer cells—even a small group of cells within a tumor—contain molecular changes that make them insensitive to a particular drug before treatment even begins. Because cancer cells within the same tumor often have a variety of molecular changes, this so-called intrinsic resistance is common.
How long can a lung cancer patient live without treatment? ›Without treatment, the outlook for lung cancer is poor. A 2013 review of studies found that the average survival time for people with NSCLC who do not receive treatment is just over 7 months . A 2012 review found that the survival time for untreated SCLC is in the range of 2–4 months.
What happens if you don't get treatment for lung cancer? ›Doctor's Response. More than half of lung cancer patients will die within one year of diagnosis even with treatment. Without treatment, patients may die even sooner. For any hope of survival, medical or surgical treatment is necessary.
Can you fully beat lung cancer? ›Survival for all stages of lung cancer
around 40 out of every 100 people (around 40%) survive their cancer for 1 year or more. around 15 out of every 100 people (around 15%) will survive their cancer for 5 years or more. 10 out of every 100 people (10%) will survive their cancer for 10 years or more.
Screening for lung cancer can save lives.
For patients who have small, early-stage lung cancer, the cure rate can be as high as 80% to 90%. Cure rates drop dramatically as the tumor becomes more advanced and involves lymph nodes or other parts of the body.
- liver.
- pancreas.
- ovaries.
- brain (glioblastomas)
- cells that give your skin color (melanomas)
The difficulty in treating cancer is that it's not a single disease, but rather a group of diseases. In total there are more than 100 different types of cancers. Cancers are also caused by different things, so no one strategy can prevent them.
Why do some cancers suddenly disappear without treatment? ›One likely reason for spontaneous regression is that the body triggers an immune response against specific antigens displayed on the surface of tumour cells.
How fast does untreated lung cancer progress? ›Studies have shown that lung cancer doubling time can vary, from 229 days to 647 days in one study, depending upon the type. 7 It's possible that some types of lung cancer progress within weeks to months, while others may take years to grow.
How fast does untreated lung cancer spread? ›
A 2018 study found that the median doubling time varies by type of NSCLC: Adenocarcinomas had a median doubling time of 261 days. Squamous cell carcinomas had a median doubling time of 70 days. Other lung cancers, which included large cell carcinomas and SCLC, also had a median doubling time of 70 days.
Where does lung cancer usually spread to first? ›Where does lung cancer spread? When lung cancer spreads, or metastasizes, it can move to nearby tissues or to more distant areas in the body. While it's possible for lung cancer to spread virtually anywhere, it most commonly metastasizes in the liver, brain, bones or adrenal glands.
Can you live with incurable lung cancer? ›Your lung cancer may be incurable, but, with good treatment and ongoing care, you can lead a relatively normal life. With improvements in treatment and care, people are not only living longer with lung cancer, they are enjoying a better quality of life.
Can lung cancer be cured without chemo? ›Treating stage 0 NSCLC
Because stage 0 NSCLC is limited to the lining layer of the airways and has not invaded deeper into the lung tissue or other areas, it is usually curable by surgery alone. No chemotherapy or radiation therapy is needed.
Surgery. NSCLC that hasn't spread and SCLC that's limited to a single tumor can be eligible for surgery. Your surgeon might remove the tumor and a small amount of healthy tissue around it to make sure they don't leave any cancer cells behind.
Can you live 20 years after lung cancer? ›The results show that patients diagnosed with lung cancer at an early stage via CT screening have a 20-year survival rate of 80 percent. The average five-year survival rate for all lung cancer patients is 18.6 percent because only 16 percent of lung cancers are diagnosed at an early stage.
What is best lung cancer treatment? ›If surgery isn't an option, combined chemotherapy and radiation therapy may be your primary treatment. For advanced lung cancers and those that have spread to other areas of the body, radiation therapy may help relieve symptoms, such as pain.
Which cancers have the worst prognosis? ›...
Contents
- 1.1 Lung cancer.
- 1.2 Breast cancer.
- 1.3 Prostate cancer.
- 1.4 Childhood cancer.
- Pancreatic cancer.
- Mesothelioma.
- Gallbladder cancer.
- Esophageal cancer.
- Liver and intrahepatic bile duct cancer.
- Lung and bronchial cancer.
- Pleural cancer.
- Acute monocytic leukemia.
Cancer is known for being needy and clingy in a relationship and such behavior doesn't end after a breakup. They still won't let go. Cancer holds on in the belief that the situation can be salvaged. They are convinced the remedy is simply trying to give the other person more love, passion, and nurturing.
Why do cancers lack confidence? ›
Sensitive Cancers can lose confidence quickly, especially when it comes to their close personal relationships. Cancers care so much about their friends and family, any tension in those relationships can send them on a self-doubt spiral, wondering what they said or did wrong.
Can lung tumor be cured? ›Lung cancer is treated in several ways, depending on the type of lung cancer and how far it has spread. People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments.
What stops tumors from growing? ›Tyrosine kinase inhibitors (TKIs) block chemical messengers (enzymes) called tyrosine kinases. Tyrosine kinases help to send growth signals in cells, so blocking them stops the cell growing and dividing. Cancer growth blockers can block one type of tyrosine kinase or more than one type.
Do some cancers go away on their own? ›It's rare for cancer to go away on its own without treatment; in almost every case, treatment is required to destroy the cancer cells. That's because cancer cells do not function the way normal cells do.
Can exercise shrink tumors? ›Exercise may be a cancer fighter
A study published in 2021 found that exercise may help halt or slow the growth of tumors. The study raises the possibility that exercise kills cancer cells. Exercise causes your body to release proteins called myokines into your blood.
- a cough that doesn't go away.
- a change in a cough you have had for a long time.
- breathlessness.
- unexplained weight loss.
- ongoing chest infections.
- coughing up blood.
- a hoarse voice.
- difficulty swallowing.
Patients can (and usually do) live with lung cancer for many years before it becomes apparent. Early lung cancer is largely asymptomatic and internalisation of tumours means patients are not alerted by obvious physical changes.
What is the slowest growing lung cancer? ›Lung carcinoid tumors are uncommon and tend to grow slower than other types of lung cancers. They are made up of special kinds of cells called neuroendocrine cells. They are usually classified as typical or atypical carcinoids. Carcinoids are very rare, slow-growing and most commonly treated with surgery.
Why is treating lung cancer early so difficult? ›As lungs are an internal organ, they cannot be externally examined, and symptoms only occur once the cancer has advanced. This makes it extremely difficult for lung cancer to be detected early.
What type of lung cancer does not spread? ›A stage I lung cancer is a small tumor that has not spread to any lymph nodes. Stage I is divided into 2 substages based on the size of the tumor: Stage IA tumors are 3 centimeters (cm) or less in size. Stage IA tumors may be further divided into IA1, IA2, or IA3 based on the size of the tumor.
What are the signs that lung cancer has spread? ›
- Bone pain (like pain in the back or hips)
- Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain.
Chest pain: When a lung tumor causes tightness in the chest or presses on nerves, you may feel pain in your chest, especially when breathing deeply, coughing or laughing.
What feeds lung cancer? ›There is no evidence to show any one food causes lung cancer. There is some evidence that eating red meat, processed meat and drinking alcohol could raise your risk of lung cancer but more studies need to be done to know for sure.
What is the main reason for lung cancer? ›Cigarette smoking is the number one cause of lung cancer. Lung cancer also can be caused by using other types of tobacco (such as pipes or cigars), breathing secondhand smoke, being exposed to substances such as asbestos or radon at home or work, and having a family history of lung cancer.
What is the average life expectancy with lung cancer? ›Life expectancy for people with metastatic or metastasized lung cancer is low. The 5-year survival rate for small cell lung cancer is 3%, and 8% for non-small cell lung cancer (NSCLC). 25-30% of people with metastatic NSCLC have a life expectancy of under 3 months.
How does lung cancer progress to death? ›Sometimes, the tumors shut down an organ. Other times, cancer interferes with the normal functioning of those organs and causes other complications. Lung cancer that spreads to the liver can interfere with the organ's ability to remove toxins from the body, which can cause them to build up and lead to death.
Can you be cancer free from lung cancer? ›Lung cancer is similar to other solid tumors such as breast cancer and colon cancer in which long-term remission is possible, but healthcare providers are hesitant to say cases are ever cured.
How quickly does lung cancer spread? ›Rapid growing, with a doubling time of less than 183 days: 15.8% Typical, with a doubling time of 183 to 365 days: 36.5% Slow growing, with a doubling time of over 365 days: 47.6%
Can lung cancer go into remission without treatment? ›Spontaneous remission of cancer is defined as the remission of cancer without any treatment, or with treatment that would not be expected to cause a tumor to decrease as much as it does. Spontaneous remission may be partial or complete and may be temporary or permanent.
What is the most treatable type of lung cancer? ›- Germ cell tumors: These cancers are very treatable and often curable. ...
- Lymphomas: These malignant tumors start in the lymphatic system and include Hodgkin's lymphoma and non-Hodgkin's lymphoma. ...
- Teratomas: These malignant tumors are made of cysts that contain one or more layers of embryonic cells.
Can you slow down lung cancer? ›
Targeted therapies (also known as biological therapies) are medicines designed to slow the spread of advanced non-small cell lung cancer. Targeted therapies are only suitable for people who have certain proteins in their cancerous cells.
How fast does lung cancer progress without treatment? ›A 2018 study found that the median doubling time varies by type of NSCLC: Adenocarcinomas had a median doubling time of 261 days. Squamous cell carcinomas had a median doubling time of 70 days. Other lung cancers, which included large cell carcinomas and SCLC, also had a median doubling time of 70 days.
What is the most aggressive form of lung cancer? ›Small Cell Lung Cancer (SCLC)
These cancers are the most aggressive form of lung cancer and usually affect smokers. SCLC spreads rapidly, often before people notice symptoms. The cancer usually starts in the central airways of the lungs (bronchi).
Why are some cancers inoperable? Although many tumors, such as lung, kidney, or breast cancer, do form masses that can be treated surgically, some cannot. This may be because the tumor is in a sensitive location such as the spinal cord, where surgical removal could critically damage surrounding tissue.
Why is Stage 4 lung cancer not curable? ›By stage 4, cancerous cells have spread beyond the lung where the cancer initially developed. Late stage lung cancer can be difficult to treat.
What is the most effective treatment for lung cancer? ›Radiation therapy
It's often combined with chemotherapy treatments. If surgery isn't an option, combined chemotherapy and radiation therapy may be your primary treatment. For advanced lung cancers and those that have spread to other areas of the body, radiation therapy may help relieve symptoms, such as pain.
Small Cell Lung Cancer
It is a fast-growing cancer that spreads much more quickly than other types of lung cancer. There are two different types of small cell lung cancer: Small cell carcinoma (oat cell cancer; most small cell lung cancers are of the oat cell type)
While it's possible for lung cancer to spread virtually anywhere, it most commonly metastasizes in the liver, brain, bones or adrenal glands.
Which lung cancer has worse prognosis? ›The 5-year survival rate for all people with all types of lung cancer is 22%. The 5-year survival rate for men is 18%. The 5-year survival rate for women is 25%. The 5-year survival rate for NSCLC is 26%, compared to 7% for small cell lung cancer.
What are the hardest cancers to get rid of? ›- liver.
- pancreas.
- ovaries.
- brain (glioblastomas)
- cells that give your skin color (melanomas)
What cancers are hardest to survive? ›
Cancer survival rates by cancer type
The cancers with the lowest five-year survival estimates are mesothelioma (7.2%), pancreatic cancer (7.3%) and brain cancer (12.8%). The highest five-year survival estimates are seen in patients with testicular cancer (97%), melanoma of skin (92.3%) and prostate cancer (88%).
Stage 4 lung cancer usually has a poor prognosis. One study found that depending on the stage of the metastases (spread) the average survival time following diagnosis of stage 4 lung cancer ranged from 6.3 months to 11.4 months.