Metastatic Lung Cancer Treatment

Question 1

Where does metastatic lung cancer typically spread?

Answer

Lung cancer (both small and non-small) commonly spreads to the following sites:

Brain
Bones
Adrenal glands, which are located near the kidneys
Pleura, or the thin layers of tissue that wrap around the outside of the lungs
Liver

Question 2

What are the symptoms of metastatic lung cancer?

Answer

The lungs do not have pain receptors. For this reason, many people have no symptoms when lung cancer is limited to the lungs. As a result, many lung cancer patients are diagnosed after the disease has metastasized, or spread to another area of the body.

Symptoms of metastatic lung cancer depend on where the disease has spread. For instance, bone pain (such as hip pain) is common if lung cancer spreads to the bones. When cancer spreads to the brain, symptoms might include vision changes, headaches, dizziness or weakness in an arm or leg.

The lymph nodes, such as those in the neck, may also be swollen when lung cancer metastasizes.

Question 3

If another type of cancer, such as breast or liver cancer, spreads to the lungs is it considered lung cancer?

Answer

No, a cancer that spreads to the lungs from another part of the body is not considered lung cancer. Cancers are named for the site where they first grow. So breast cancer that spreads (or metastasizes) to the lungs is considered breast cancer. The cancer cells found in the lung would be breast cancer cells not lung cancer cells.

Question 4

What is oligometastatic lung cancer and how is it diagnosed?

Answer

“Oligometastasis” is Greek for “a few that spread.” Oligometastatic lung cancer is defined loosely as lung cancer that has spread to a limited number of sites in the body. Typically, this means five or fewer sites, but can mean as many as 10 or more sites.

UChicago Medicine’s Limited Metastatic Cancer Program is internationally renown for advancing the diagnosis and treatment of oligometastatic cancers, including lung cancer. Many patients are adding years to their lives with treatment regimens designed to curtail the spread of cancer. In rare cases, these treatments offer a cure.

Our cancer experts determine on a case-by-case basis whether a patient’s lung cancer can be classified as oligometastatic. In general, we look at the overall burden of disease in addition to the number of sites that lung cancer has spread to. For example, a patient might be diagnosed with oligometastatic lung cancer if her cancer has spread to seven sites but with small amounts of cancer in each site. At the same time, another patient with only three sites of spread but with large amounts of cancer in one of the sites might also be diagnosed as oligometastatic cancer.

Other factors may also be considered when diagnosing oligometastatic lung cancer, including a previous history of cancer, the pace at which the cancer is spreading, and overall health.

Our cancer team may order various tests to assist in making a diagnosis, including imaging exams and a biopsy (the removal of a small amount of cancerous tissue).

Question 5

Drug Therapy

Answer

Three types of drug therapies are used to treat lung cancer:

Targeted drug therapy, which is prescribed when laboratory tests identify a treatable genetic mutation in cancer cells. A number of new targeted therapies have been introduced in recent years, including ones that target HER2 lung cancers. Most targeted drug therapies are oral medicines (pills) but some are given via an IV.
Immunotherapy, or drugs that help the body’s immune system fight cancer.
Chemotherapy, or drugs that fight or kill cancer cells.

Question 6

Radiation Therapy

Answer

Patients with oligometastatic lung cancer may receive radiation therapy to specific sites where their lung cancer has spread. The treatment is intended to kill cancer cells in those specific sites and prevent the cancer from spreading to other sites. Patients typically receive five radiation sessions, which has been shown safe and effective in reducing cancer spread.

Question 7

Surgical Options

Answer

When appropriate, patients with oligometastatic lung cancer may have tumors removed surgically. Our lung cancer surgeons are experts at performing robotic and other minimally invasive operations, which helps ensure that patients have shorter recovery times and fewer complications.

Question 8

Advanced Metastatic Lung Cancer

Answer

When a patient’s lung cancer is more advanced, our goals are to help patients live as long and as well as possible. We may recommend drug therapy to shrink the tumors, which can help improve quality of life and extend life.

Surgery is not typically performed in late-stage lung cancer. However, radiation may be used to shrink tumors with the goal of relieving symptoms and improving quality of life.