Understanding Metastatic Lung Cancer: How It Spreads and How It’s Treated

Metastatic lung cancer or stage 4 lung cancer happens when cancer cells from the lungs spread to other parts of the body, such as the liver, bones, or brain. This type of cancer is also called advanced or secondary lung cancer. It develops when the disease moves beyond the lungs and starts affecting other organs.

Advanced lung cancer is usually not curable, but treatments can help control the disease. They may slow cancer growth, reduce symptoms, and improve a person’s quality of life for some time. Sometimes cancer is already advanced when it is first diagnosed. In other cases, it can return after treatment, which doctors call recurrent lung cancer.

What Are the Symptoms of Metastatic Lung Cancer?

Metastatic lung cancer doesn’t always cause symptoms, especially in its early stages. When symptoms do appear, they vary depending on where the cancer has spread. Here’s a look at common areas affected and the symptoms linked with each.

Adrenal Glands

• Often cause no noticeable symptoms.
• Large tumors may lead to pain in the back or abdomen.
• If both glands are severely affected, adrenal insufficiency may occur, leading to:
  • Fatigue and weakness
  • Nausea and vomiting
  • Fever
  • Loss of appetite

Brain

• About 40% of individuals with non-small cell lung cancer experience brain metastases.
• Possible symptoms include:
  • Headaches or dizziness
  • Fatigue or weakness in parts of the body
  • Nausea or vomiting
  • Difficulty concentrating or confusion
• A clinical trial for non-small cell lung cancer is currently taking place to explore new and more effective treatment options for patients.

Bones

• Around one-third of people with advanced lung cancer develop bone metastases.
• Common signs include:
  • Persistent or worsening bone pain
  • Pain that increases at night or during movement
  • Weakened bones that break more easily

Lymph Nodes

• Swollen lymph nodes in the neck, armpits, or abdomen may indicate cancer spread.
• However, lymph nodes can also enlarge due to infections or other health conditions, so further tests are needed for confirmation.

Liver

• When cancer spreads to the liver, symptoms may include:
  • Pain or discomfort in the upper abdomen
  • Constant tiredness
  • Nausea or reduced appetite
  • Jaundice (yellowing of the skin and eyes)

Also Read: Lung Cancer in the Upper Region of the Lung: Understanding Pancoast Tumors

Diagnosis of Lymphoma

Diagnosing lymphoma involves several tests and procedures to confirm the disease, determine its type, and assess how far it has spread. Doctors usually follow these steps:

1. Physical Examination

The doctor starts by examining your body for swollen lymph nodes in areas like the neck, armpits, and groin. They may also check the spleen and liver for enlargement. Your medical history and symptoms are discussed to guide the next steps.

2. Blood Tests

Blood tests help evaluate the overall health of your blood cells and organ function. They also give clues about how the body is responding to potential cancer and help rule out other conditions with similar symptoms.

3. Imaging Tests

• CT scan (Computerized Tomography): Creates detailed pictures of areas inside your body to locate enlarged lymph nodes or affected organs.
• PET Scan (Positron Emission Tomography): Produces a 3D color image to detect whether lymphoma has spread to other parts of the body, including the bone marrow.
• MRI Scan (Magnetic Resonance Imaging): Occasionally used to check areas like the brain and spinal cord if lymphoma involvement is suspected there.

4. Lymph Node Biopsy

A biopsy is the most crucial step for confirming lymphoma. A surgeon removes all or part of an affected lymph node. Pathologists examine the tissue under a microscope to identify lymphoma cells and determine the specific type (Hodgkin or Non-Hodgkin).

5. Bone Marrow Biopsy

Doctors may perform a bone marrow biopsy to check whether lymphoma cells have spread to the bone marrow. This helps in staging the disease and planning treatment.

6. Additional Tests (if needed)

Sometimes, tests like flow cytometry, immunohistochemistry, or genetic analysis are done on biopsy samples to provide more information about the lymphoma subtype and its characteristics.

7. Staging the Lymphoma

Once all tests are complete, doctors determine the stage of lymphoma (I–IV), which indicates how far the cancer has spread. Staging guides treatment decisions and helps predict outcomes.

Read More: Understanding Large Cell Lung Carcinoma (LCLC): Diagnosis, Stages, and Causes

Treatment of Metastatic Lung Cancer

When lung cancer spreads to other parts of the body, it becomes more challenging to remove it completely. At this stage, treatment mainly focuses on controlling cancer growth, easing symptoms, and improving quality of life. The choice of treatment depends on several factors, including the type of lung cancer, location of the metastases, previous treatments, and the patient’s overall health. Doctors often combine different therapies to achieve the best possible outcome.

Here are the main treatment options used for metastatic lung cancer or stage 4 lung cancer:

1. Chemotherapy

Chemotherapy remains one of the most common treatments. It uses powerful drugs that travel through the bloodstream to kill cancer cells throughout the body. Although side effects can occur, newer medications and supportive therapies help manage them effectively.

2. Targeted Therapy and Biological Therapy

These treatments work by focusing on specific genetic changes or proteins that help cancer cells grow. Targeted therapies and biological drugs often cause fewer side effects than chemotherapy and can be highly effective for people whose cancer has certain mutations.

3. Immunotherapy

This approach helps the body’s own immune system recognize and attack cancer cells. Immunotherapy has become an important option for many patients with advanced lung cancer and can sometimes lead to longer-lasting control of the disease.

4. Radiation Therapy

Radiation therapy can shrink tumors in specific areas, such as the brain, bones, or chest, to relieve pain or breathing difficulties. It’s often used when metastases cause discomfort or pressure on nearby organs.

5. Supportive (Palliative) Care

Alongside cancer treatment, supportive care plays a vital role. Medications and therapies are used to reduce pain, ease breathing problems, manage fatigue, and improve comfort. The goal is to help patients maintain the best possible quality of life.

Read More: Is Lung Cancer Hereditary? Understanding the Role of Genetics in Lung Cancer

Clinical Trials: Paving the Way for Lung Cancer Breakthroughs

Clinical trials continue to drive progress in metastatic lung cancer treatment by introducing innovative therapies like targeted drugs and immunotherapies. Clinical research studies in Nebraska aim to improve survival and quality of life for patients. For example, a small cell lung cancer (SCLC) clinical trial is evaluating investigational treatments that offer new hope for patients with limited options.

Conclusion:

In conclusion, metastatic lung cancer remains a serious condition, but advancements in treatment and ongoing clinical trials conducted by clinical research organizations are bringing new possibilities for care. Early diagnosis, personalized therapies, and supportive treatment can help manage symptoms, extend survival, and improve quality of life for patients living with advanced lung cancer.