Lung metastases
Metastases to the lung; Metastatic cancer to the lung; Lung cancer - metastases; Lung mets
Lung metastases are cancerous tumors that start somewhere else in the body and spread to the lungs.
Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.
A lateral view of a chest x-ray in a patient with central cancer of the lung.
A chest x-ray in a patient with central cancer of the right lung. Notice the white mass in the middle portion of the right lung (seen on the left side of the picture).
This x-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.
This CT scan shows a single lesion (pulmonary nodule) in the right lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.
This CT scan shows a cross section of the lungs of a person with lung cancer. The two dark areas in the middle of the screen are the lungs. The light areas in the right lung (on the left of the screen) represent the cancer.
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Causes
Metastatic tumors in the lungs are cancers that developed at other places in the body (or other parts of the lungs). They then spread through the bloodstream or lymphatic system to the lungs. It is different than lung cancer that starts in the lungs.
Nearly any cancer can spread to the lungs. Common cancers include:
- Bladder cancer
- Breast cancer
- Lung cancer
- Colorectal cancer
- Kidney cancer
- Melanoma
- Ovarian cancer
- Sarcoma
- Thyroid cancer
- Pancreatic cancer
- Testicular cancer
Cancer can affect just about any part of the body, from the colon to the pancreas. Some cancers grow quickly, while others grow more slowly and are easier to treat. But of all the different cancers out there, one of the deadliest is lung cancer. Let's talk today about lung cancer. Cancer starts when cells begin to grow uncontrollably and form tumors. In the case of lung cancer, the tumors start in the lungs. Sometimes cancer starts somewhere else in the body and then spreads to the lungs. In that case, it's called metastatic cancer to the lung. Metastatic means disease that has spread. There are two types of lung cancer. The most common, and slower-growing form is non-small cell lung cancer. The other, faster-growing form is called small cell lung cancer. The most common way to get lung cancer is to smoke cigarettes. The more cigarettes you smoke and the earlier you start smoking, the greater your risk is. Even being around someone who smokes and breathing in the secondhand smoke from their cigarettes increases your risk of getting lung cancer. Even though smoking makes you much more likely to get lung cancer, you don't have to smoke or be exposed to smoke to get the disease. Some people who have lung cancer never lit up a cigarette in their life. They have been exposed to cancer-causing substances like asbestos, diesel fumes, arsenic, radiation, or radon gas. Or, they may not have had any known lung cancer risks. The most common signs of lung cancer are a cough that won't go away, chest pain, shortness of breath, weight loss, and fatigue. But just because you have these symptoms it doesn't mean that you have don't have lung cancer. These can also be signs of other conditions, like asthma or a respiratory infection. If you do have these symptoms, see your doctor. A chest x-ray, MRI, or CT scan can view the inside of your lungs to look for signs of cancer or other diseases. What happens if you do have lung cancer? Doctors divide lung cancer into stages. The higher the stage, the more the cancer has spread. For example, a stage 1 cancer is small and hasn't spread outside of the lungs. A stage 4 cancer has spread to the other organs, such as the kidneys or brain. Depending upon the type and stage of your lung cancer, you may need surgery to remove part or all of your lung. Or, your doctor may recommend radiation or chemotherapy to kill cancer cells. If you have lung cancer, how well you do depends upon the stage of your disease and the type of lung cancer that you have. Early-stage cancers have the highest survival and cure rates. Late-stage cancers are harder to treat. Because lung cancer can be so deadly, prevention is key. The most important that thing you can do is to stop smoking, and avoid being around anyone who does smoke.
Symptoms
Symptoms may include any of the following:
- Bloody sputum
- Chest pain
- Cough
- Shortness of breath
- Weakness
- Weight loss
Exams and Tests
The health care provider will examine you and ask about your medical history and symptoms. Tests that may be done include:
- Bronchoscopy to view the airways
- Chest CT scan
- Chest x-ray
- Cytologic studies of pleural fluid or sputum
- Lung needle biopsy
- PET scan
- Surgery to take a sample of tissue from the lungs (surgical lung biopsy)
Treatment
Chemotherapy is often used to treat metastatic cancer to the lung. Surgery to remove the tumors may be done when any of the following occurs:
- The cancer has spread to only limited areas of the lung
- The lung tumors can be completely removed with surgery
However, the main tumor must be curable, and the person must be strong enough to go through the surgery and recovery.
Other treatments include:
- Radiation therapy
- Immunotherapy
- Targeted systemic therapy
- The placement of stents inside the airways
- Laser therapy
- Using local heat probes to destroy the area
- Using very cold temperature to destroy the area
Support Groups
You can ease the stress of illness by joining a support group where members share common experiences and problems.
Outlook (Prognosis)
A cure is unlikely in most cases of cancers that have spread to the lungs. But the outlook depends on the main cancer. In some cases, a person can live more than 5 years with metastatic cancer to the lungs.
Possible Complications
Complications of metastatic tumors in the lungs may include:
- Fluid between the lung and chest wall (pleural effusion), which can cause shortness of breath or pain when taking a deep breath
- Further spread of the cancer
When to Contact a Medical Professional
Call your provider if you have a history of cancer and you develop:
- Coughing up blood
- Persistent cough
- Shortness of breath
- Unexplained weight loss
Prevention
Not all cancers can be prevented. However, many can be prevented by:
- Eating healthy foods
- Exercising regularly
- Limiting alcohol consumption
- Not smoking
References
Arenberg DA, Reddy RM. Metastatic malignant tumors. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 79.
Hayman J, Naidoo J, Ettinger DS. Lung metastases. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 57.
Wald O, Izhar U, Sugarbaker DJ. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 58.
Version Info
Last reviewed on: 4/29/2022
Reviewed by: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
