If you receive a lung cancer diagnosis, your oncologist will likely perform additional tests to determine whether the cancer has spread to other areas of the body. Depending on your specific results, your doctor will develop and discuss a treatment plan that is right for you.
This article provides an overview of areas where lung cancer can metastasize, including signs and symptoms. It also discusses diagnosis and treatment options for lung cancer that has spread.
Like many other types of cancer, lung cancer can spread to other parts of the body from the original tumor site.
The National Cancer Institute (NCI) explains that tumor cells can travel in a series of ways:
- by spreading into tissue directly near the primary tumor
- traveling through blood vessels
- traveling through the lymphatic system
Some cancer cells can then attach to the wall of a blood vessel and move through it into healthy tissue. When these cells start multiplying, they create a metastatic tumor in the new location.
When a new tumor forms, it is still the same type of cancer as the original tumor. For example, if lung cancer spreads to the bones, those cancer cells are called metastatic lung cancer, not bone cancer.
The areas where lung cancer may spread can differ according to the specific type of lung cancer.
In a 2020 data analysis, researchers found that the most common sites of metastasis were the bones and brain for non-small cell lung cancer (NSCLC) and the liver and bones for SCLC.
Where lung cancer spreads
According to the NCI, the most common areas for lung cancer metastasis are:
- bone
- liver
- brain
- adrenal gland(s)
Talk with your oncologist or lung cancer care team right away if you experience new or worsening symptoms during your lung cancer treatment.
Bones are a common site of lung cancer metastasis, particularly in advanced lung cancer.
The
- ribs
- thoracic spine
- lumbar spine
Symptoms that can develop due to cancer in the bones
- pain that ranges from occasional to constant and becomes more severe over time
- fractures during everyday activities due to weakened bones
- symptoms of spinal cord compression
- symptoms of high blood calcium
- frequent urination
- constipation
- excessive thirst
- fatigue or sleepiness
For people with SCLC, the liver is the most common area of lung cancer metastasis.
Symptoms of cancer in the liver include:
- abdominal pain, particularly in the upper right abdomen or through the right shoulder
- vomiting
- lump that develops below the rib cage on the right
- loss of appetite
- feeling full quickly, even with a small amount of food
- jaundice, which is yellowing of the eyes and skin
- swelling in the lower limbs or abdomen
Lung cancer is the most common source of brain metastasis, according to 2020 research cited by a 2022 study.
The rates of lung cancer spread to the brain are similar for both NSCLC and SCLC. A 2020 data analysis found that brain metastasis develops in 16.7% of people with NSCLC or SCLC.
According to the American Lung Association, in about 25% of people with lung cancer, the cancer has already spread to the brain at the time of diagnosis.
Symptoms of cancer in the brain include:
- headache
- sleepiness or fatigue
- loss of mobility in certain areas of the body
- memory loss
- seizures
- vomiting or nausea
- changes in senses, such as vision or hearing
- personality changes
Your adrenal glands are on the top of each kidney. They produce hormones including adrenaline and cortisol.
Lung cancer is the
In most cases, cancer in the adrenal glands does not produce symptoms. When symptoms do occur, they can include back pain or abdominal pain.
If you receive a diagnosis of a primary lung tumor, your oncologist likely will screen you for metastatic tumors. This will help your doctor stage your lung cancer and develop your treatment plan.
Tests your lung cancer care team may order or perform include:
- Imaging: Tests such as a PET scan, MRI, or CT scan can help doctors identify the location and size of a metastatic tumor.
- Blood: Elevated levels of specific substances in your blood can indicate cancer in a specific organ, such as the liver or adrenal glands.
- Biopsy: If other tests indicate a metastatic tumor, your doctor may remove a sample for testing to confirm the diagnosis.
The spread of lung cancer to other areas of the body commonly requires additional treatments. While it is often not possible to cure metastatic lung cancer, there are many treatments to help slow the progression of tumors and manage symptoms.
Depending on your diagnosis, treatment options for stage 4 lung cancer may include:
- surgery to remove metastatic tumors, if possible
- targeted therapy, which can treat tumors with specific genetic factors
- radiation therapy focused on the area of metastasis
- immunotherapy, which enhances your own immune system’s ability to target cancer cells
- chemotherapy, which targets cancer cells throughout the body
Some people may choose palliative care that focuses on managing pain and allowing for the best possible quality of life. Your doctor will discuss the benefits and risks of all treatment options in the context of your personal treatment goals.
The most common areas where lung cancer spreads are the bones, liver, brain, other lung, and adrenal glands. This is known as metastatic lung cancer, also called stage 4 lung cancer.
Non-small cell lung cancer is most likely to spread to the bones and brain. The liver, bones, and brain are the most common areas of spread for small cell lung cancer.
Alert your oncologist or lung cancer care team right away if you experience any new or worsening symptoms. By identifying cancer spread early, they can develop a treatment plan to manage symptoms and slow the progression of new tumors.