Metastatic Lung Cancer

It’s common for non-small cell cancer cells to grow outside of the lungs into the bones. It’s estimated that about 1/4 to 1/3 of people with this type of lung cancer will have metastatic lung cancer in the bones. Lung cancer often spreads to the spine, hip, ribs or thigh bones.

Lung cancer that has spread to the brain is found in both small cell lung cancer and non-small cell lung cancer cases. However, the growth rate of small cell lung cancer tends to be more rapid. Approximately 40% of individuals diagnosed with lung cancer eventually experience metastatic brain cancer.

In both small cell lung cancer and non-small lung cancer, cancer can spread to the adrenal glands. These glands make hormones and are located near the kidneys.

Liver metastases are most common in people with advanced small cell lung cancer. If you have lung cancer that has spread to your liver, your treatment plan may include procedures that deliver therapy directly to these areas of cancer.

Nearby lymph nodes are often one of the first places that lung cancer spreads, even in earlier stages of cancer. But when lung cancer cells start to spread to lymph nodes farther away from the original cancer site, then your cancer may be classified as metastatic cancer.

Sometimes, lung cancer will spread from one lung to the other. This is more common with non-small cell lung cancer. People who have lung cancer that spreads to the other lung tend to have a better prognosis than when lung cancer spreads to distant locations in the body.

When you have symptoms of a lung condition, your doctor will review your medical history and perform a routine exam. During your exam, your doctor listens to your chest and heart and looks for any signs that might be caused by lung cancer.

A chest X-ray is one of the leading imaging tests to screen and diagnose lung cancer. However, additional types of imaging tests can help your care team find signs of cancer that has spread. 

• Computed tomography (CT): A CT scan uses multiple X-ray images to give your doctor a more detailed look at your lungs or other body areas.
• Positron emission tomography (PET): A PET scan is helpful in the diagnosis and staging of lung cancer. It uses a substance to highlight cancer cells on images, showing your doctor if and where cancer has spread in the body.
• Magnetic resonance imaging (MRI): An MRI uses magnets and radio waves to create images of your body and look for signs of metastatic lung cancer. For example, you may have an MRI of your brain to see if lung cancer has spread there.
• Bone scan: A bone scan is sometimes used in metastatic lung cancer diagnosis to determine if cancer has spread to the bones. Like PET scans, bone scans use a substance to highlight cancer cells.

Blood tests don’t diagnose metastatic lung cancer but give your care team valuable information about your overall health. They can tell your doctor how well specific organs that may be affected by cancer work.

• Complete blood count (CBC): A CBC is a routine blood test that shows your general health, specifically, how many of each type of blood cell you have in your blood.
• Electrolyte panel: If the levels of electrolytes in your blood, such as sodium, potassium or magnesium, are off, it might signal a kidney problem.
• Liver function tests: A liver function test checks for signs that your liver isn’t working as it should.
• Oxygen saturation: When you have lung cancer, it can affect your lungs and their ability to give your body enough oxygen. Oxygen saturation measures the level of oxygen found in your blood.
• Tumor marker tests: Tumor marker blood tests look for specific proteins related to cancer that may be in the blood.

Bronchoscopy is one of the main procedures for diagnosing lung cancer. It uses a thin tube with a camera attached, called an endoscope, to go through the mouth or nose and down into the airways. During a bronchoscopy, your care team can examine areas of your lungs, take biopsies or perform other procedures.

If your care team finds an area of concern on imaging, you may have a biopsy to confirm whether the nodule or mass is lung cancer. During a biopsy, your doctor takes tissue or fluid samples, which a pathologist reviews under a microscope to look for cancer cells.

Depending on your specific needs, there are a few different ways to take a lung biopsy. Some biopsies are taken using a hollow needle inserted through the chest. In other cases, you may need an endoscopic procedure like bronchoscopy or a surgical procedure to allow your care team to reach the area that needs to be biopsied.