Table of ContentsView AllTable of ContentsWhat Causes It?What Is My Risk?SymptomsDiagnosisTreatmentPrognosisHow to Cope
Table of ContentsView All
View All
Table of Contents
What Causes It?
What Is My Risk?
Symptoms
Diagnosis
Treatment
Prognosis
How to Cope
Metastatic lung cancer is cancer that has spread (metastasized) from the lungs to other parts of the body, such as the liver or brain. While early-stagelung canceris oftenasymptomatic(without symptoms), metastatic lung cancer invariably causes symptoms like shortness of breath, difficulty swallowing, finger clubbing, and coughing up blood.
Although metastatic lung cancer is typically incurable and challenging to treat, newer drugs are improving survival times and quality of life for people diagnosed with this most advanced stage of lung cancer.
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What Causes Metastatic Lung Cancer?
Lung cancer is the third leading cause of cancer in the United States and the number one cause of cancer-related deaths. In 2023, an estimated 234,580 people were newly diagnosed with the disease, while 125,070 lung cancer deaths were reported.
In total, lung cancer accounts for nearly 12% of all cancers in the U.S. and just over 20% of cancer-related deaths.
The high rate of lung cancer deaths is attributed to the fact that no less than 53% of all diagnoses are made when the cancer has already undergonemetastasis.
How Metastasis Occurs
Metastasis (plural -metastases) occurs when pieces of the original (primary) tumor break off and migrate through thecirculatoryorlymphatic systemto establish new tumors in other parts of the body. The most common sites for metastasis for lung cancer are:
Lung cancer may be classified as metastatic upon the initial diagnosis or later on following treatment if the cancer suddenly spreads.
Correct TerminologyIf lung cancer spreads to the brain, for example, the new cancer is not referred to as brain cancer. To better characterize the disease, the condition would be referred to as “lung cancer metastatic to the brain” or “brain metastasis in lung cancer.” In this instance, the lung tumor is theprimary cancerand the brain tumor is the secondary cancer.
Correct Terminology
If lung cancer spreads to the brain, for example, the new cancer is not referred to as brain cancer. To better characterize the disease, the condition would be referred to as “lung cancer metastatic to the brain” or “brain metastasis in lung cancer.” In this instance, the lung tumor is theprimary cancerand the brain tumor is the secondary cancer.
What Is My Risk of Metastatic Lung Cancer?
One of the main risk factors for lung cancer metastasis is the type of cancer you have. According to a 2017 study in theAnnals of Thoracic Medicine,there are four main types of lung cancer that vary in their risk of metastasis:
Thegrade of the canceralso factors into the risk of metastasis. Some lung cancers are high-grade, meaning that they are very aggressive, while others are low-grade, meaning that they are less aggressive. Those in between are of intermediate grade.
Signs and Symptoms of Metastatic Lung Cancer
Even when lung cancer is advanced, thesymptomscan be relatively subtle or easily mistaken for less serious conditions.
Symptoms of lung cancer include:
With metastases, other symptoms can develop:
How Metastatic Lung Cancer Is Diagnosed
Thediagnosis of lung cancerinvolves lab tests, imaging studies, and other tests. Once the disease is definitively diagnosed with alung biopsy, the cancer is staged.Stagingestablishes how advanced the cancer is so that the appropriate treatment can be delivered.
Key to staging is the presence or absence of metastasis, often found with imaging studies likemagnetic resonance imaging (MRI)orpositron emission tomography (PET).
Adenocarcinoma, SCC, and LCC all belong to a group of cancers callednon-small cell lung cancer (NSCLC), which accounts for around 85% of lung cancers. Small cell lung cancers (SCLC) are an entirely different type of cancer which represents the remaining 15%.
NSCLC and SCLC can involve different staging systems.
Cancer Stage vs. Tumor GradeCancer staging is not the same thing as tumor grading. Staging is used to determine the extent of the disease, while grading evaluates the characteristics of a tumor to determine how aggressive it is.
Cancer Stage vs. Tumor Grade
Cancer staging is not the same thing as tumor grading. Staging is used to determine the extent of the disease, while grading evaluates the characteristics of a tumor to determine how aggressive it is.
TNM Classification
The TNM system is described in four stages (stage 1, stage 2, stage 3, and stage 4) with stage 4 being the most advanced.
If metastasis is found, the disease is classified asstage 4.
SCLC Staging
SCLC is classified into two stages with a specific course of treatment for each stage:
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How Metastatic Lung Cancer Is Treated
Metastatic lung cancer israrely curedand difficult to treat. Treatment is often focused onpalliative care—used to ease symptoms, extend life, and improve the quality of life—rather than attempting to cure cancer.
Treating Stage 4 NSCLC
The approach to treating stage 4 NSCLC can differ based on an evaluation of your tumor.
If genetic testing reveals that your tumor has certain gene mutations (such asKRAS. EGFR, ALK. ROS1, BRAF, RET, MET,orNTRK), thentargeted drug therapywill often be the first-line treatment.
These include targeted drugs like:
If testing reveals that your tumor has high levels of the PD-L1 protein, thenimmunotherapy drugs(known as immune checkpoint inhibitors) may be prescribed with or withoutchemotherapy.
Immunotherapy options include:
The treatment of stage 4 NSCLC may also involve surgery,radiation, different types of chemotherapy, or a combination of these,
Options for SCLC
With extensive-stage SCLC, cancer has spread too far for surgery or radiation therapy to be successful as an initial treatment. As such, chemotherapy and immunotherapy are used in the first-line treatment.
Immunotherapy drugs used for extensive-stage SCLC include:
If cancer responds to this, then radiation therapy may be introduced. The goal of radiation is to help prolong life; radiation might also be considered to prevent cancer progression in the brain.
The prognosis (expected outcome) for metastatic lung cancer is measured in terms of therelative five-year survival rate. A five-year survival rate is the percentage of people who are expected to live for at least five years after diagnosis.
The survival rate is deemed “relative” because it involves all people diagnosed with lung cancer in the United States irrespective of their age, general health, or type of cancer they have.
Survival rates only vary the extent of cancer in the body, described as:
Extentof Spread% of CasesRelative 5-Year SurvivalLocalized22%63.7%Regional21%35.9%Distant53%8.9%This is a significant advance from 2013 when the five-year survival rate for localized, regional, and distant lung cancer was 58.9%, 32.9%, and 6.3% respectively. The introduction of newer drugs and diagnostic techniques will almost certainly improve them further.It is important to remember that survival rates for lung cancer are based onallpeople with the disease. As such, your results may be far better if your general health is good andyou remain healthy and active.How to Cope With Metastatic Lung CancerDuring treatment, your healthcare provider, medical team, family, and friends can help you cope with metastatic lung cancer lifestyle changes, symptoms, and treatment side effects. Reach out to them for help and emotional supportYou can also consider these measures:Educate yourself: Get information about the disease, metastasis, staging, and treatments. Some people find that increasing their knowledge in these areas helps them face what’s ahead. Ask your medical team as many questions as you need to.Work with your care team: Get a referral to a healthcare professional who you can talk to about your worries, emotions, and situation. They will be able to help you with coping strategies, psychological support, and lifestyle changes.Build a support network: Sometimes it helps to speak to other people who have been through or are in the same cancer stage as you. Ask your healthcare provider about localsupport groupsthat you could attend, or seek out online support or social media groups.Focus on quality of life: Give yourself time to do something that makes you happy. Plan your activities for times of the day when you have the most energy and not much else to do.If you are worried about how your family is coping with your diagnosis,encourage them to seek help too. There are in-person and online support groups for family members and caregivers just like there are for patients.SummaryMetastatic lung cancer describes cancer that has spread from the primary site in a lung to other parts of the body. Symptoms include persistent cough, shortness of breath, coughing up blood, finger clubbing, and other signs based on where in the body the cancer has spread.Metastatic lung cancer is generally incurable; treatment is focused on easing symptoms and improving survival and quality of life. Depending on the type of lung cancer you have, this may involve surgery, chemotherapy, radiation, immunotherapy, and targeted drugs.
This is a significant advance from 2013 when the five-year survival rate for localized, regional, and distant lung cancer was 58.9%, 32.9%, and 6.3% respectively. The introduction of newer drugs and diagnostic techniques will almost certainly improve them further.
It is important to remember that survival rates for lung cancer are based onallpeople with the disease. As such, your results may be far better if your general health is good andyou remain healthy and active.
How to Cope With Metastatic Lung Cancer
During treatment, your healthcare provider, medical team, family, and friends can help you cope with metastatic lung cancer lifestyle changes, symptoms, and treatment side effects. Reach out to them for help and emotional support
You can also consider these measures:
If you are worried about how your family is coping with your diagnosis,encourage them to seek help too. There are in-person and online support groups for family members and caregivers just like there are for patients.
Summary
Metastatic lung cancer describes cancer that has spread from the primary site in a lung to other parts of the body. Symptoms include persistent cough, shortness of breath, coughing up blood, finger clubbing, and other signs based on where in the body the cancer has spread.
Metastatic lung cancer is generally incurable; treatment is focused on easing symptoms and improving survival and quality of life. Depending on the type of lung cancer you have, this may involve surgery, chemotherapy, radiation, immunotherapy, and targeted drugs.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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