Yes; but, not all.

Before explaining what stage 4 cancer is, one should understand two terms – 'primary' and 'secondary' cancer sites. The organ at which the doctor initially detected cancer is known as the primary site of cancer; and, the secondary site is the organ where cancer has further spread. In general, cancer is considered curable if it is confined to the primary organ or region (stage 1 to 3); and incurable if it has spread to secondary sites (stage 4).

Usually, the life expectancy of a stage 4 cancer patient ranges from a few months to 1-2 years, depending on the type of cancer. However, in the last decade, various studies have confirmed that at least some of these stage 4 cancers, if treated aggressively, are potentially curable.


But, not all stage 4 cancer patients would be eligible for these curative treatments. There are three main criteria for selecting a patient for such a therapy:

1. These cancers should be limited to a confined number of organs, usually 3.
2. The total number of cancer lesions in these three organs combined should be less than 5.
3. The size of secondary cancer should be less than 3 to 5 cm, ideally less than 3 cm.

Nevertheless, according to the newer guidelines, all those cancer nodules that can be safely and effectively ablated or operated on should be considered for curative therapies. In oncology practice, these types of stage 4 cancers are called oligometastatic cancers or low-burden cancers.


Which are those low-burden cancers proven to be curable? Intestinal and kidney cancers are proven to be curable by several studies. Nevertheless, fourth stage cancers of other areas, such as in the head and neck region, thorax, abdomen, pelvis, and certain types of skin cancers, show a trend towards curability; however, further confirmatory studies are awaited.

How is it possible to cure low-burden cancers? Thanks to a better understanding of cancer biology, and technological advancements in oncology, it is possible now. For instance, the doctor can selectively ablate the cancer cells while saving the normal tissues surrounding cancer with the help of the latest radiotherapy machines and technologies. This precise and focused radiation technique to the cancer cells is called stereotactic body radiotherapy (SBRT or SABR). Similarly, minimally invasive surgical procedures used in the surgical oncology field help the doctor accurately excise cancer without additional morbidity. Radiofrequency ablation and microwave ablation are other local therapies that can be used to kill cancer cells effectively. 

Even though ineligible for curative treatment, in other low-burden cancers – such as prostate cancer, melanoma (a type of skin cancer), lung cancer, and breast cancer – aggressive therapies have led to an increase in the survival rates of patients. Some patients live for more than 5 to 10 years. However, one needs to be continually treated from time to time. Closer follow-up scans are necessary to pick up an early recurrence. Any recurrence must be hunted down with the help of radiation, surgery, and other systemic therapies. With these close follow-up visits and focused local treatments, I believe that cancer can be converted to a chronic illness, such as diabetes and hypertension.


The bottom line is that one shouldn't lose heart if your near and dear one is diagnosed with stage 4 cancer. Technologies used in the medical field have advanced compared to yesteryears. Now doctors have many weapons in their armamentarium to fight against this 'not so deadly' disease.