Metastatic Lung Cancer

Overview

Lung cancer is a type of cancer that begins in the lung. When lung cancer spreads beyond its initial site, this is known as metastatic lung cancer. There are two main types of metastatic lung cancer:

• Non-small-cell lung cancer – about 85 percent of metastatic lung cancer cases are of this type.
• Small-cell lung cancer – the remaining 15 percent of metastatic lung cancer cases are of this type.

The most common areas of the body to which lung cancer metastasizes are:

• Adrenal glands
• Bones
• Brain
• Liver
• Lymph nodes

Metastatic lung cancer causes

This condition is caused by mutations (changes) to the DNA of the cells of the lung.

Metastatic lung cancer risk factors

The following factors may increase your risk for developing metastatic lung cancer:

• Being a smoker
• Being exposed to radon, asbestos or other harmful workplace substances
• Being exposed to secondhand smoke
• Having a personal or family history of lung cancer
• Having high levels of arsenic in your drinking water
• Having undergone radiation therapy to the lungs
• Living in an area with high levels of air pollution
• Taking certain supplements, including beta carotene

Metastatic lung cancer symptoms

Symptoms of metastatic lung cancer depend on the site of the cancer spread.

If the lung cancer has metastasized to the adrenal glands, you may experience:

• Decreased appetite
• Fatigue
• Fever
• Nausea
• Pain in your back or abdomen
• Vomiting
• Weakness

If the lung cancer has metastasized to the bone, you may experience:

• Increased bone fractures

If the lung cancer has metastasized to the brain, you may experience:

• Confusion
• Headaches
• Nausea
• Tiredness
• Weakness

If the lung cancer has metastasized to the liver, you may experience:

• Decreased appetite
• Nausea after eating
• Pain under the right ribs
• Jaundice (yellowing of the whites of the eyes and skin)

If the lung cancer has metastasized to the lymph nodes, you may experience:

• Enlarged lymph nodes in your armpit, neck or stomach

Metastatic lung cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors.
• Biopsy – in this test, your doctor removes a biopsy (small tissue sample) from the lung. This sample is sent to the laboratory, where a specialist closely checks the biopsy for abnormalities.
• Blood tests – your doctor will send a sample of your blood to the laboratory for close analysis. The lab technician checks your blood for liver, kidney, blood count and other factors that could indicate metastatic lung cancer.
• Bone scan – this test can help your doctor determine if cancer has spread to your bones.
• Computerized tomography (CT) scan – this type of imaging test provides a 3D image of the inside of the body that your doctor can use to determine if there is any cancer present.
• Magnetic resonance imaging (MRI) – this type of imaging test uses high-powered magnets to create detailed images of the inside of your body. Your doctor can closely examine these images to look for any areas that could indicate cancer.
• Positron emission tomography (PET) scan – your doctor may use this type of imaging test to check for metastatic lung cancer that may have spread to the brain.
• Ultrasound – this type of imaging test uses sound waves to create detailed images of the inside of your body. Your doctor can closely examine these images to look for any areas that could indicate cancer.

Metastatic lung cancer treatment

Depending on your personal health history, the extent of the metastatic lung cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Chemotherapy – you may need to undergo chemotherapy to destroy cancerous cells. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. 
• Targeted therapy – this treatment focuses on the molecular changes that make cancer cells grow and spread. These therapies are less likely than chemotherapy to harm healthy cells and may have fewer side effects. 

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.