What is metastatic lung cancer?

Metastatic lung cancer, also known as stage 4 lung cancer, is the most advanced type of lung cancer. The term metastatic cancer means that the cancer cells have spread to distant areas in the body, away from their original location in the lung.

As this type of lung cancer has spread and affects other tissues and organs, it’s more difficult to treat than early-stage lung cancer. But you do have treatment options. Your care team will work with you to plan your next steps and improve your quality of life with metastatic lung cancer.

Woman with metastatic lung cancer sitting in a kayak, holding an oar, as her husband pushes the ka

Where does lung cancer spread?

Over time, lung cancer cells may spread to nearby areas in the chest, nearby lymph nodes or the other lung. The cells can also eventually travel through the blood vessels or lymph system to other places in the body. When this happens, tumors may form in areas like the bones or brain.

Bones

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.

What causes metastatic lung cancer, and how does it spread?

Metastatic lung cancer develops over time. As lung cancer grows, it invades tissues near the lungs first. Eventually, these cancer cells may move into the lymphatic vessels through a lymph node or blood vessel. Through these vessels, cancer cells can travel through the body and get into other tissues. Cancer cells form a metastasis or tumor when they divide and grow in this new location.

Metastatic lung cancer symptoms

Many people don’t have symptoms in the early stages of lung cancer, and they don’t start to appear until the cancer has spread. When symptoms do start, they may be subtle or easy to miss. Because of this, more than 50% of people already have metastatic lung cancer when they are first diagnosed with the condition.

In addition to general lung cancer symptoms, like a cough, shortness of breath, chest pain or ongoing chest infections, metastatic lung cancer symptoms depend on the area of the body where cancer has spread.

Some symptoms might include:

  • Headaches, dizziness, balance and vision changes, or seizures when lung cancer has spread to the brain.
  • Swollen belly or yellowing of the skin and eyes in lung cancer that has spread to the liver.
  • Bone pain or fractures when lung cancer has spread to the bones.
  • Digestive issues, abdominal pain, weight loss, fatigue or back pain in lung cancer that has spread to the adrenal glands.
Older man with metastatic lung cancer sitting on hospital bed, smiling at the camera with a female

Lung cancer metastasis and staging

Metastasis is one of three main factors used by your care team in lung cancer staging, along with the original tumor size and location and whether it has spread into lymph nodes. Understanding if you have a lung metastasis and where the cancer has spread is important to planning your next steps in treatment. For example, lung cancer that hasn’t spread or metastasized is often treated with surgery, whereas metastatic lung cancer may not be.

Non-small cell lung cancer stage 4

Non-small cell lung cancer (NSCLC) is typically placed into stage 0 to stage 4 based on where and how far the lung cancer cells have spread. Stages 4A and 4B are the most advanced types of lung cancer, and most cases of metastatic NSCLC fall into one of these two substages:

  • Non-small cell lung cancer stage 4A: In stage 4A lung cancer, you have additional tumors to the original tumor in your lung. Your cancer has also spread to the lining or fluid around the lungs and either to the other lung or another distant organ in the body.
  • Non-small cell lung cancer stage 4B: Stage 4B lung cancer has spread in the chest and to more than one distant area in the body. It’s the most advanced and widespread stage of non-small cell lung cancer.

Small cell lung cancer stage 4

Small cell lung cancer (SCLC) is grouped into one of two stages: limited-stage or extensive-stage small cell lung cancer.

  • Limited-stage SCLC: In limited-stage small cell lung cancer, the cancer cells are still only in one lung and may have spread to some nearby lymph nodes. More treatment options are available at this stage.
  • Extensive-stage SCLC: Extensive-stage small cell lung cancer is metastatic lung cancer and similar to stage 4 cancer. It has spread to the other lung or other organs away from the original tumor’s location.


How is metastatic lung cancer diagnosed?

Along with tests that initially diagnose cancer, you may have blood tests to check on your overall health or imaging tests that help stage your cancer and look at how far it has spread in the body.

Medical history and physical exam

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.

Treating metastatic lung cancer

While metastatic lung cancer is more challenging to treat, you still have lung cancer treatment options to manage symptoms and improve your overall quality of life. At this stage, surgery to altogether remove your cancer is not usually part of your care plan. Treatments like chemotherapy, radiation therapy or immunotherapy are more common.

Your care team will also carry out treatments focused on relieving pain or caring for the emotional, mental or social effects of metastatic lung cancer. Your care plan will be tailored to your unique needs and goals.

Nurse navigator sitting next to female metastatic lung cancer patient, explaining available support

Compassionate support at any stage of lung cancer

No matter the stage or type of lung cancer, you aren’t alone in your fight. You have numerous resources available to support you and your family every step of the way. Navigating metastatic lung cancer can feel complex. At our facilities, you can access many resources to feel informed, confident and comfortable.

Connect with us to get the support you need for metastatic lung cancer.

Cancer support groups and programs
Caregiver support
Clinical Research
Financial counselors
Patient navigation and social work
Spiritual care
Supportive palliative care

Connect with a nurse navigator

Nurse navigators, sometimes called patient navigators or care coordinators, are healthcare experts with specialized training and cancer experience. Navigators are available to guide and support you throughout your cancer journey. Navigators can help you with the following:

  • Educating you about your care and next steps
  • Help with understanding your diagnosis, treatment options and follow-up care needs.
  • Connecting you with supportive services and resources such as financial, transportation and support groups.
  • Assisting with communication between you and your healthcare team.
  • Removing barriers to care
  • Providing ongoing emotional support throughout your cancer journey into survivorship

Contact your local patient navigator today

Nurse navigator holding the hand of a metastatic lung cancer patient during treatment.