Metastatic cancer to the lung

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Alternative names
Lung metastases

Definition
When cancer cells from another organ spread to the lungs, they are said to have metastasized to the lung.

Causes, incidence, and risk factors
Metastatic tumors in the lungs are malignancies (cancers) that developed at other sites and spread via the blood stream to the lungs. Common tumors that metastasize to the lungs include breast cancer, colon cancer, prostate cancer, sarcoma, bladder cancer, neuroblastoma, and Wilm’s tumor. However, almost any cancer has the capacity to spread to the lungs.

Symptoms

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

Note: Sometimes, there are no symptoms.

Signs and tests

• Chest X-ray
  
• Chest CT scan
  
• Cytologic studies of pleural fluid or sputum
  
• Bronchoscopy
  
• 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 by surgery is usually not beneficial. Chemotherapy is usually the treatment of choice.

Cure is unlikely in most cases. Patients with testicular cancer or lymphoma, however, have a higher likelihood of long-term survival and cure compared with those with most other cancers.

In some circumstances in which the primary tumor has been removed and cancer has spread to only limited areas of the lung, the lung metastases can be removed surgically with the goal of long-term survival or, occasionally, cure.

Radiation therapy, the placement of stents inside the airways, or laser therapy are sometimes used but are less common than surgery or chemotherapy.

Support Groups
The stress of illness can often be helped by joining a support group where members share common experiences and problems. For this condition, see cancer support group.

Expectations (prognosis)

Living more than 5 years with metastatic cancer to the lungs is uncommon. 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 have spread to the lung can be cured with chemotherapy. However, this is the exception rather than the rule. In general, lung metastases are a sign of widespread cancer with a poor survival rate.

Complications

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

Calling your health care provider
Patients with a history of cancer who develop persistent cough, bloody sputum (coughing up blood), shortness of breath, unexplained weight loss, or other significant changes in their health should contact their health care provider.

Prevention

Not all cancers can be prevented, but many can be by not smoking, eating a healthy diet, exercising regularly, and keeping alcohol consumption moderate.

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