Lung cancer spreads or metastasizes faster than most malignant disorders. Two-thirds of lung cancer patients receive a late-stage diagnosis, which is when metastasis has already occurred or is underway. Furthermore, malignant lung tumors have a preferred path of spread, commonly metastasizing to the bones, liver, adrenal glands, and brain.
Reasons Lung Cancer Spreads So Fast
Spreading might be uncomplicated for lung cancers since the organ affected is a major cellular traffic hub inside the body. “The job of the airway is to deliver oxygen to all of your cells, and it is easy for your cells to get from the airway lining to your blood, to spread to other organs,” explained Paul Bunn, MD, professor of medical oncology at the University of Colorado in Denver, to Everyday Health.
Where Lung Cancer Cells Prefer to Go and Why
When lung cancer spreads, it has a tendency to settle into certain areas because “some organs produce a cellular signal that draws a particular cancer into it,” uttered Douglas Arenberg, MD, professor of pulmonary and critical care medicine at the University of Michigan Medical School in Ann Arbor.
The cells of lung tumors have receptors on the surface. These receptors match the proteins that the bones, liver, adrenal glands, and brain create. The lung tumor cells are somehow attracted to those proteins, and the organs producing said proteins are the common sites for lung cancer metastases. Scientists and oncologists sometimes refer to this phenomenon as the “seed and soil hypothesis,” wherein the tumor is the seed and the soil is receptive to that seed.
Cancers are always named after the area in the body where they begin. Therefore, if lung cancer spreads elsewhere, it is called “metastatic lung cancer.”
Common Sites of Metastatic Lung Cancer
Although lung cancer can travel and invade many different areas of the body, certain places are more susceptible.
- Bones. About 30 to 40 percent of people who have advanced non-small cell lung cancer may develop bone metastases at some point during treatment or survivorship. A lung malignancy that metastasizes to the bones usually impacts the ribs, spine, pelvis, and long bones in the body. Moreover, lung cancer can reach and invade the bones in the hands and feet. In a majority of cases, metastasis is only found when it begins to cause pain and other physical problems. Imaging tests such as an X-ray, bone scan, PET scan, MRI scan, and CT scan can help find cancer that has spread to the bones.
- Liver. Most lung tumors that make their way to the liver invade other areas of the body simultaneously. Lung cancer that spreads to the liver might not cause any symptoms at first. When symptoms occur, they often include loss of appetite, fever, nausea, pain in the upper right portion of the stomach, night sweats, unintended weight loss, and jaundice (yellowing of the skin and/or whites of the eyes). Oncologists can order tests such as a CT scan, PET scan, and abdominal ultrasound to detect lung cancer spread in the liver.
- Adrenal glands. The adrenal glands (small glands sitting above the kidneys) are one of the most common sites for lung cancer metastasis. In many cases, cancer that spreads to the adrenal glands does not cause signs and symptoms. In rare cases, it may lead to abdominal or back pain. Your doctor may perform various imaging tests to see if cancer of the lung has reached the adrenal glands.
- Brain. Studies revealed that about 16 to 20 percent of lung cancer patients will develop brain metastases. The risk is higher for people with certain forms of tumor mutations. Symptoms of brain metastases include recurrent headaches, seizures, loss of balance or coordination problems, speech difficulties, forgetfulness changes in vision, and constant fatigue. Diagnosticians can detect lung cancer that has invaded the brain by performing a CT and/or MRI scan.
In some cases, lung cancer can also spread to other areas of the body, including the small and large intestines, pancreas, kidneys, breasts, skin, and eyes.
Does Lung Tumor Size Matter?
“There is a misconception that when cancer reaches a certain size, it’s capable of spreading, but there is not any given size threshold that allows cancer to metastasize,” said Arenberg. Some malignant disorders metastasize even before they are detectable.
That being said, larger lung tumors have a higher chance of finding their way elsewhere in the body. “One way to look at a tumor is that every day, it is sort of playing the lottery,” he explained. “The more cells there are, the more likely it is that a few will win the lottery and gain the ability to invade the bloodstream or lymph system,” Arenberg added. Early detection is often essential to a good prognosis.
The Importance of Routine Screening in Detecting Metastasis
Several tests, including blood tests, bone scans, CT scans, and MRI scans can help detect lung cancer metastasis. The specific tests your doctor may perform will depend on your symptoms and overall condition.
In addition, although doctors can treat metastatic lung cancer to alleviate certain symptoms and improve your quality of life, keep in mind that there is no cure just yet. The generally accepted course of action, tells Arenberg, is to disclose all symptoms to your healthcare team and then address the metastases to control any problems and improve your overall quality of life.
Symptoms to Look For
Talk to your doctor if you experience any symptoms that are out of the ordinary, and especially those that could signal metastatic lung cancer, such as:
- Any new pain or discomfort
- Anything that suggests neurological symptoms, including headaches, weakness, or any changes in your ability to walk or grip objects
- Loss of appetite and unintended weight loss
- Constant and unexplained fatigue
- Jaundice
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