The Voice
What Happens When Lung Cancer Spreads?
It may come as a surprise to anyone who has ever found themselves with bronchitis or lungs burning after an intense run, but the lungs themselves don’t have very many pain receptors.1 Unfortunately, this means that in the case of lung cancer, it is often difficult for patients to know that they have lung cancer until the cancer has already spread beyond the lungs. In this blog post we will take a look at what happens when lung cancer spreads, and patient options at that point.
When lung cancer spreads:
The new cancer site is called a metastasis, and when the lung cancer spreads to multiple places, these new occurrences are called metastases.2 The most common place for lung cancer to spread is (perhaps unsurprisingly) from one lung to the other.2 When cancer has just started spreading and has not yet spread to other locations, it is known as local cancer, or oligometastatic(from the Greek word for ‘few that spread’)1. If the cancer spreads to nearby lymph nodes this can also accelerate metastasis as the cancer travels through the lymphatic system and settles in other organs.2 At that point it is referred to as a distant metastasis.1 Although lung cancer may spread to places like the bones, it would still be referred to as lung cancer metastasized to the bones.
Types of Lung Cancer and How They Spread:
There are different types of lung cancer, some of which spread aggressively, and others that are less likely to spread quickly. 2 To figure out which type of lung cancer someone has, doctors stage the cancer, which involves looking at the tumor, the nearby lymph nodes and then performing MRIs or PET scans to see if tumors have spread anywhere else (TNM method).
One 2024 study found that Small-Cell Lung Cancer showed the most distant metastasis (56.74%), followed by Large Cell Neuroendocrine Carcinoma (47.52%), Adenocarcinoma (43.36%), Large Cell Carcinoma (40.61%), Adenosquamous Carcinoma (36.69%), Squamous Cell Carcinoma (26.54%), and at the lowest rate, typical and atypical combined (9.18%).3 Small-Cell Lung Cancer is usually not classified using the TNM system, and is usually categorized as ‘limited stage’ or ‘extensive stage.’
Treatment Options When Lung Cancer Has Spread:
Treatment Options When Lung Cancer Although metastatic cancer is considered advanced cancer and is rarely curable, newer medications are improving palliative care, which still increases patient quality of life and increasing how long lung cancer patients survive. 2
When lung cancer is oligometastatic, it may be treated with radiation, which targets cancer cells in certain spots with the goal of preventing further spread. Surgeons may also use newer, minimally invasive surgical techniques (using tiny robots and cameras) to target tumors. For certain types of metastatic lung cancer, doctors may be able to use targeted drug therapy. There is also the option of using traditional chemotherapy, or immunotherapy, which boosts the body’s immune system if the cancer tests positive for a certain type of protein, called PD-L1. Even if lung cancer has spread to distant organs, doctors may still recommend radiation or drug therapy to shrink the size of tumors and improve patient quality of life.1
Special Considerations for Small Cell Lung Cancer:
Due to its aggressive nature, Small-Cell Lung Cancer may need specific treatments, including combined chemotherapy, with Alex Prossor noting that radiotherapy, chemotherapy and immunotherapy can all help relieve symptoms, while immunotherapy and chemotherapy may shrink the size of tumors as well.4
Sources
- Metastatic Lung Cancer Treatment | University of Chicago Medicine
- Metastatic Lung Cancer: Symptoms and Treatment | Verywell Health
- Distant Metastasis Patterns Among Lung Cancer Subtypes | Nature Scientific Reports
- Metastatic Small Cell Lung Cancer: A Complete Guide | Healthgrades