Non-small cell lung cancer (NSCLC) is the most common kind of lung cancer. When NSCLC spreads to other parts of the body, it’s known as metastatic NSCLC.
There are four stages of NSCLC, with stage 4 being the most severe. While this cancer can spread to lymph nodes starting in stage 2A, stage 4 is when the cancer cells have spread to other areas in the chest or other parts of the body.
Treatment for metastatic NSCLC is often aimed at reducing symptom severity and prolonging life expectancy. It isn’t curable, but it’s still possible to enjoy a strong quality of life. In this article, we’ll go over what metastasis is, how it’s treated, the outlook, and more.
When cancer has spread out from where it started to other areas of the body, it is called metastasized cancer. The process by which cancer cells spread is called metastasis.
Cancer cells can travel from the main tumor to other areas of the body in two ways:
- Lymph system. The cancer travels through the lymph vessels to another area of the body.
- Blood. The cancer travels through the bloodstream to a new area and forms a new tumor.
When cancer has metastasized, the new tumors are still the same kind of cancer as the original cancer, no matter where they are found in the body. If NSCLC has metastasized to the brain, it’s not considered brain cancer — it’s lung cancer that has moved to the brain.
Common places for NSCLC to spread
The most common places for NSCLC to spread include the:
- adrenal glands
Many lung cancers don’t show any symptoms until they’ve started to spread. But some people do have symptoms, even with early-stage lung cancers. Many of the symptoms can also be symptoms of other illnesses, so it’s not always easy to diagnose.
Symptoms of NSCLC — with or without metastasis — can include:
- a consistent cough that doesn’t go away
- coughing up blood or rust-colored mucus
- chest pain that tends to get worse with breathing or laughing
- loss of appetite
- shortness of breath
- fatigue or weakness
- infections like bronchitis and pneumonia that keep recurring or don’t go away
- new wheezing
If the lung cancer has metastasized, the symptoms can vary. The symptoms are often related to the area of the body to which the cancer has spread.
Symptoms can include:
- bone pain
- dizziness, balance problems, or weakness if the cancer has spread to the brain
- yellowing of the skin and eyes if it has spread to the liver
- swelling of lymph nodes in neck or near the collarbone
Sometimes some lung cancers can cause syndromes, or groups of symptoms. These can include:
- Horner syndrome. This can cause drooping or weakness of one upper eyelid, small pupils, or little-to-no sweating on one side of the face.
- Superior vena cava syndrome. This can cause swelling in the face, neck, arms, and upper chest. It can also cause headaches and pain, and affect consciousness.
- Paraneoplastic syndromes. Hormones can travel through the blood and cause issues in distant sites where there is no cancer present.
For NSCLC that has metastasized, treatment can depend on where and how far the cancer has spread, certain characteristics of the cancer cells like proteins or genes, and your general health.
This stage of cancer is difficult to treat. Many treatments aim to relieve symptoms and prolong life, and are less about curing the cancer.
Treatments can include:
According to the American Cancer Society, the estimated 5-year survival rates for NSCLC are:
- localized: 63 percent
- regional: 35 percent
- distant: 7 percent
- all stages combined: 25 percent
These are not definitive survival rates, and everyone is different. These should be taken as an estimated guide and not the rule. Many things can affect your specific outlook, including:
- your overall health
- your age
- your race
- your response to treatment
- genetic mutations
- tumor location and cancer type
- whether you currently smoke
- your activity level
When NSCLC spreads to other areas of the body, it is metastatic cancer.
Although metastatic NSCLC is rarely curable, there are treatments that are available that can help relieve symptoms, prolong your life, and improve your quality of life.
Depending on where your cancer has spread, your treatment might look different from that of someone else with metastatic NSCLC.
Together with your doctor, you can discuss the goals and expectations of your treatment, which treatment may be best for your situation, and ways to handle symptoms and any side effects.