Metastatic cancer to the lung

Definition

Metastatic cancer to the lung is cancer that starts somewhere else in the body and spreads to the lungs.

See also: Lung cancer

Alternative Names

Lung metastases

Causes, incidence, and risk factors

Metastatic tumors in the lungs are cancers that developed at other sites and spread through the bloodstream or lymphatic system to the lungs. Common tumors that spread to the lungs include:

• Bladder cancer
• Breast cancer
• Colon cancer
• Neuroblastoma
• Prostate cancer
• Sarcoma
• Wilm's tumor

However, almost any cancer has the ability to spread to the lungs.

Symptoms

• Bloody sputum
• Cough
• Rib cage pain
• Shortness of breath
• Weakness
• Weight loss

Note: In most cases, there are no lung-related symptoms when the tumors are found.

Signs and tests

• Bronchoscopy
• Chest CT scan
• Chest x-ray
• Cytologic studies of pleural fluid or sputum
• Lung needle biopsy
• Surgical lung biopsy

Treatment

In most cases, metastatic cancer to the lung is a sign that the cancer has spread into the bloodstream. Usually cancer will be present even in places not seen by CT scans. In these circumstances, removing the visible tumors with surgery is usually not beneficial. Chemotherapy is usually the treatment of choice.

Sometimes when the primary tumor has been removed and the cancer has spread to only limited areas of the lung, the lung tumors can be removed with surgery. However, the main tumor must be curable, the lung tumors must be able to be completely cut out, and the patient must be strong enough to go through the surgery and recovery.

Other, less common treatments include:

• Radiation therapy
• The placement of stents inside the airways
• Laser therapy

There are other experimental treatments. One of these treatments uses local heat probes to destroy the area. Another drips chemotherapy directly into the artery that supplies blood to the part of the lung containing the tumor.

Support Groups

You can ease the stress of illness by joining a support group where members share common experiences and problems. For this condition, see cancer support group.

Expectations (prognosis)

A cure is unlikely in most cases. It is rare for someone to live more than 5 years with metastatic cancer to the lungs.

Rarely, patients with certain types of cancer (sarcoma, renal cell carcinoma, bladder cancer, colon cancer, or melanoma) that has only spread a limited amount to the lung can be cured with surgery. Some types of cancer (particularly lymphoma or testicular cancer) that has spread to the lung can be cured with chemotherapy.

Complications

• Fluid around the heart (pericardial effusions), which can cause shortness of breath
• Fluid between the lung and chest wall (pleural effusions), which can cause shortness of breath
• Further spread of the cancer
• Side effects of chemotherapy and radiation therapy

Calling your health care provider

Call your health care provider if you have a history of cancer and you develop:

• Coughing up blood (bloody sputum)
• Persistent cough
• Shortness of breath
• Unexplained weight loss

Prevention

Not all cancers can be prevented. However, many can be prevented by:

• Eating a healthy diet
• Exercising regularly
• Limiting alcohol consumption
• Not smoking

References

Rusch VW. Lung metastases. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKenna WG. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 58.