Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Lung cancer is the leading cause of cancer deaths in the United States, among both men and women.
Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. People who smoke have the greatest risk of lung cancer, though lung cancer can also occur in people who have never smoked.
About advanced cancer
The risk of lung cancer increases with the length of time and number of cigarettes you've smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer. Lung cancer care at Mayo Clinic. Lung cancer typically doesn't cause signs and symptoms in its earliest stages.
Signs and symptoms of lung cancer typically occur only when the disease is advanced.
When Lung Cancer Spreads to Bone
Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. If you smoke and have been unable to quit, make an appointment with your doctor. Your doctor can recommend strategies for quitting smoking, such as counseling, medications and nicotine replacement products. Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke.
In these cases, there may be no clear cause of lung cancer. Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances carcinogenschanges in the lung tissue begin almost immediately. At first your body may be able to repair this damage.
But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.
Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have.
A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can't be controlled, such as your family history. Fluid in the chest pleural effusion. Lung cancer can cause fluid to accumulate in the space that surrounds the affected lung in the chest cavity pleural space. Fluid accumulating in the chest can cause shortness of breath. Treatments are available to drain the fluid from your chest and reduce the risk that pleural effusion will occur again.
Cancer that spreads to other parts of the body metastasis. Lung cancer often spreads metastasizes to other parts of the body, such as the brain and the bones. Cancer that spreads can cause pain, nausea, headaches, or other signs and symptoms depending on what organ is affected.We know that this is an especially worrying time for people with cancer and their family and friends.
We have separate information about coronavirus and cancer. Please read that information alongside this page. We will update that information as guidance changes. Read about coronavirus and cancer. It is also called metastatic cancer. This is called fluid on the lung or a pleural effusion. But treatment can control it, relieve symptoms, and give you a good quality of life for a while.
A cancer might be advanced when it is first diagnosed. Or it may come back some time after you were first treated. This is called recurrent cancer. For example, it may grow into an airway, the chest wall or the membranes that surround the lung the pleura. A cancer that has spread to another part of the body is called a secondary cancer or metastasis. Not all lung cancers will spread. But if the cancer does spread there are certain parts of the body that it is more likely to go to.
The most common areas for lung cancer to spread to are:. It can help to find out more about your cancer and the treatments you might have. Many people find that knowing more about their situation can make it easier to cope. Many people want to know what the outlook is and how their cancer will develop.
This is different for each person. Your cancer specialist has all the information about you and your cancer. About Cancer generously supported by Dangoor Education since Questions about cancer?
Call freephone or email us. Skip to main content. Lung cancer. Lung cancer Advanced cancer. Where lung cancer spreads A cancer that has spread to another part of the body is called a secondary cancer or metastasis. The most common areas for lung cancer to spread to are: nearby lymph nodes the brain bones the liver the adrenal glands small hormone glands just above your kidney other parts of the lung or the other lung Find out about stages, types, and grades of lung cancer.Management of Metastatic Non-small Cell Lung Cancer
For information and support, you can phone the Cancer Research UK nurses onfrom Monday to Friday, 9am to 5pm. Find out about lung cancer survival. Search our clinical trials database for all cancer trials and studies recruiting in the UK.In metastasis, cancer cells break away from where they first formed primary cancertravel through the blood or lymph system, and form new tumors metastatic tumors in other parts of the body.
The metastatic tumor is the same type of cancer as the primary tumor. Cancer cells can spread locally by moving into nearby normal tissue. Cancer can also spread regionally, to nearby lymph nodes, tissues, or organs. And it can spread to distant parts of the body.
When this happens, it is called metastatic cancer. For many types of cancer, it is also called stage IV four cancer. The process by which cancer cells spread to other parts of the body is called metastasis. This is how doctors can tell that it is cancer that has spread from another part of the body. Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started.
See the Carcinoma of Unknown Primary page for more information. When a new primary cancer occurs in a person with a history of cancer, it is known as a second primary cancer. Second primary cancers are rare.
Most of the time, when someone who has had cancer has cancer again, it means the first primary cancer has returned. During metastasis, cancer cells spread from the place in the body where they first formed to other parts of the body.
Most of the time, spreading cancer cells die at some point in this process. But, as long as conditions are favorable for the cancer cells at every step, some of them are able to form new tumors in other parts of the body. Metastatic cancer cells can also remain inactive at a distant site for many years before they begin to grow again, if at all. Cancer can spread to most any part of the body, although different types of cancer are more likely to spread to certain areas than others.
Metastatic cancer does not always cause symptoms. When symptoms do occur, their nature and frequency will depend on the size and location of the metastatic tumors. Some common signs of metastatic cancer include:. Once cancer spreads, it can be hard to control. Although some types of metastatic cancer can be cured with current treatments, most cannot.Metastasis in lung cancer is a multifaceted process. In this review, we will dissect the process in several isolated steps such as angiogenesis, hypoxia, circulation, and establishment of a metastatic focus.
In reality, several of these processes overlap and occur even simultaneously, but such a presentation would be unreadable. Metastasis requires cell migration toward higher oxygen tension, which is based on changing the structure of the cell epithelial-mesenchymal transitionorientation within the stroma and stroma interaction, and communication with the immune system to avoid attack.
Once in the blood stream, cells have to survive trapping by the coagulation system, to survive shear stress in small blood vessels, and to find the right location for extravasation. Lung carcinomas when detected are most often in a metastatic stage IV.
Lung carcinomas metastasize by lymphatic as well as blood vessels. When careful evaluation is done in resected lung carcinomas, vascular invasion is often seen in low-stage tumors, which usually results in increased incidence of recurrence as well as shortened survival of the patient [ 1 ].
Whereas metastasis via the lymphatic route usually takes longer until distant metastases are set, spreading via blood vessels will set early on distant metastases. Lung carcinomas have some preferential sites for metastasis, such as the brain, bones, and adrenal glands.
Other organs are involved usually in late stage of the disease. Within the different types of lung carcinomas, there is also a preferential metastatic site, such as liver metastasis in small-cell lung carcinoma SCLC and brain metastasis in SCLC and adenocarcinoma [ 2 — 4 ]. In recent years, brain metastasis are increasingly seen in adenocarcinomas with epidermal growth factor receptor EGFR mutations and EML4ALK1 rearrangement, whereas squamous cell carcinomas in many cases have a tendency to locally invade the thoracic wall [ 45 ].
This opens a variety of questions on metastasis in lung carcinomas, which we aim to address in this review.
When dissecting metastasis into developmental steps, there are several ways to approach this theme, including the first step of invasion into the stroma. Due to space limits, we will not discuss the process of precursor to in situ carcinoma transition and also will not focus on stroma invasion. We will focus on.
After tumor cells have invaded the stroma, several tasks have to be organized. To promote tumor growth, the tumor cells need to organize vascular supply for nutrition and oxygen uptake. For movement within the stroma, this needs to be restructured; the tumor cells have to escape lymphocytic attacks; and finally, for migration, the tumor cells have to adapt to a migratory cell structure.
To facilitate angiogenesis, tumor cells can either directly release angiogenic factors such as vascular endothelial growth factors VEGFs to directly stimulate the formation of new blood vessels, or tumor cells cooperate with macrophages, which can release angiogenic growth factors [ 6 — 8 ]. To understand the function of macrophages, it is necessary to briefly discuss the two different populations of macrophages, the M1 and M2 types.
M1 macrophages are acting against tumor cell invasion by secreting interleukin 12 ILwhich function tumoricidal by an interaction with cytotoxic lymphocytes and NK cells.Brain metastases are common in people with non-small-cell lung cancer. Roughly 10 percent of patients with non-small-cell lung cancer NSCLC have brain metastases at their initial diagnosis; as many as 40 percent will eventually develop brain tumors at some stage during their illness, according to a retrospective cohort study published in August in Current Oncology.
Unlike brain cancer, which originates in the brain and consists of brain cancer cells, brain metastases from lung cancer occur when cancer cells break off from the original tumor in the lungs and enter the bloodstream or travel through the lymph system to the brain, where they begin to multiply. While metastatic lung cancer can rarely be cured, improvements in the detection and treatment of brain metastases are allowing people to live longer lives of higher quality.
As metastatic brain tumors grow, they can directly damage brain cells, or they may affect the brain indirectly by compressing parts of the brain or causing swelling and increased pressure within the skull. Early warning signs, however, can be subtle and may easily be attributed to other causes, including chemotherapy, notes Jonathan Goldman, MDan associate professor in hematology and oncology at the UCLA Jonsson Comprehensive Cancer Center.
To diagnose brain metastases, your doctor will most likely perform a neurological exam which may include checking your vision, hearing, balance, coordination, strength, and reflexes and order a magnetic resonance imaging MRI scan of your head — an MRI can not only detect cancer but precisely identify the location and size of any brain lesions.
Other imaging tests your doctor may use include positron emission tomography PET and computerized tomography CT scans. A biopsy may also be done to confirm a diagnosis and help determine the best course of treatment.
If diagnosed and treated early, brain metastases usually respond to therapy. Treatment may include:. Surgery, which may involve the complete or partial removal of a tumor to help alleviate symptoms, is typically followed by whole-brain radiation. This type of therapy involves the use of X-rays or other high-energy beams to kill cancer cells. And different methods of radiation are used to treat brain metastases. People with fewer than five lung cancer metastases in the brain may be good candidates for stereotactic radiation, in which advanced imaging and computer guidance are used to deliver large doses of radiation directly to tumors.
If you have many tumors throughout the brain, or a large tumor located deep in the brain, your doctor may recommend whole-brain radiation, in which radiation is applied to the entire brain to kill tumor cells. Systemic therapy. Systemic therapies, which include chemotherapy, targeted therapy, and immunotherapy, involve drugs that travel through the bloodstream to reach cancer cells throughout the body.
Because many chemotherapy drugs are unable to cross the blood-brain barrier — a network of capillaries that keeps certain substances from reaching the brain — targeted therapies are the primary systemic form used to treat brain metastases. Targeted therapies can identify and attack specific cancer cells with minimal harm to normal cells.
For people with lung cancer cells that have specific mutations such as EGFR and ALK mutationsthese therapies can be highly effective. Palliative care. This type of specialized medical care, which can include physical therapy, relaxation techniques, exercisespeech therapy, and pain management, is also a key component of treatment for patients with metastatic NSCLC.
These complementary approaches can help mitigate the side effects of both the cancer and its treatment and significantly improve quality of life. After surgery, radiation, or systemic treatment for brain metastases, your doctor will most likely have an MRI performed to determine how much of the tumor is gone and will continue to follow up with an MRI every few months. While the outlook traditionally was poor for people with NSCLC and brain metastases, advancements in treatment are continually improving survival rates.
Even though the cancer may have formed a tumor in a new location in the body, it is still named after the part of the body where it started. For example, if lung cancer spreads to the brain, it is called metastatic lung cancer.
The most common sites of metastases for lung cancer are the other lung, adrenal gland, bones, brain and liver. If you have been treated for lung cancer and now have cancer cells in any of these areas, it is most likely that the lung cancer has spread. Metastatic lung cancer is not the same as recurrent lung cancer. Recurrent lung cancer is cancer that returns to the same part of the same lung after treatment, rather than traveling to other parts of the body.
In all cases, a metastatic tumor is always caused by cancer cells migrating from another part of the body. In general, metastatic cancers are treated based on the original site of the cancer.
The drugs used to treat your lung cancer may be used for metastases. The cancer cells themselves have not changed but simply are living in a new place. Drug therapy is used to treat most cases of lung cancer that has spread to your liver. Radiation therapy or drug therapy are options for lung cancers that have spread to bone. Drugs would be used if you are not experiencing pain or there is no danger of bone breakage.
Radiation therapy would be used if you have pain or your bone is fragile. Make a difference in the fight against cancer by donating to cancer research. Call us anytime. Outpatient Care Centers. Becoming a Patient. Menu Search. How we treat cancer. Our locations. Becoming a patient. For physicians. Call us anytime Donate to Cancer Research Make a difference in the fight against cancer by donating to cancer research.
Donate now. Gateway for Cancer Research is a c 3 non-profit organization. Tax-ID: Skip to Content. Metastasis occurs when cancer spreads to a different part of the body from where it started. But it has not spread throughout the body.
Metastatic lung cancer
You may find the naming of metastatic cancer confusing. Doctors name a metastasis for the original cancer. For example, breast cancer that spreads to the bone is not bone cancer.
It is called metastatic breast cancer. In the past, many people did not live long with metastatic cancer. But doctors can often treat cancer even if they cannot cure it.
A good quality of life is possible for months or even years. Treatment depends on the type of cancer, the available treatment options, and your wishes. It also depends on your age, general health, treatment you had before, and other factors. Treatments for metastatic cancer include surgery, chemotherapy, hormone therapy, immunotherapy, and radiation therapy.
For many people with cancer, the goal of treatment is to try to cure the cancer. This means getting rid of the cancer and never having it come back. With metastatic cancer, curing the cancer may not be a realistic goal. However, it might still be a hope or dream. It is reasonable to ask your doctor if curing the cancer is the goal.
If curing the cancer is not the goal of treatment, the goal is to help a person live as well as possible for as long as possible. Getting more specific, this goal can be broken into 4 parts:. Each person values these items differently. It is important to tell your health care team what is important to you. Getting treatment for metastatic cancer can help you live longer and feel better.
But getting treatment is always your decision. Learn more about making decisions about cancer treatment. These recommendations include information on treating many types of metastatic cancer. When doctors can treat metastatic cancer, your situation may be like someone with a chronic, or long-term, disease.
Examples of chronic diseases are type 1 diabetes, congestive heart failure, and multiple sclerosis. Doctors can treat these conditions, but not cure them. Living with metastatic cancer is challenging. The challenges are different for everyone, but they can include:. Feeling upset that the cancer came back.