![Metastatic lung cancer is stage IV cancer, which is when lung cancer has spread (metastasized) to other parts of the body outside the lungs. The prognosis for metastatic lung cancer is usually poor. Five-year survival rates for metastatic small-cell lung cancer and non-small cell lung cancer are between 3% and 6%.](https://images.medicinenet.com/images/article/main_image/carcinoid-lung-tumors.jpg?output-quality=75)
Metastatic lung cancer, also called stage IV cancer, is lung cancer that has spread (metastasized) to other parts of the body outside the lungs, such as the brain, bones, and liver. Metastatic lung cancer generally has a poor prognosis.
Life expectancy for lung cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis.
- Five-year survival rates for metastatic non-small cell lung cancer are 6%
- Five-year survival rates for metastatic small cell lung cancer are 3%
One study found that depending on the stage of the metastases (spread) the average survival time following diagnosis of metastatic lung cancer ranged from 6.3 months to 11.4 months.
There are a number of factors that can impact life expectancy with metastatic lung cancer.
Factors associated with a less favorable outcome include:
- Older age
- Being male
- Smoking
- It’s never too late to quit. Some research found that smokers with metastatic lung cancer who quit prior to starting chemotherapy increased life expectancy by as much as 6 months in some cases.
- Location of the cancer
- How aggressive the cancer is found to be
- Other underlying health conditions
- Congestive heart failure and cerebrovascular diseases (such as stroke, aneurysm, or vascular malformation) significantly impact survival time
What Are Symptoms of Metastatic Lung Cancer?
Lung cancer may not have symptoms early on. When the first signs and symptoms do occur, they may include:
- Persistent or worsening cough
- Coughing up blood or rust-colored sputum
- Chest pain that may be worse with deep breathing, coughing, or laughing
- Hoarseness
- Loss of appetite
- Unexplained weight loss
- Shortness of breath
- Breathing problems
- Fatigue/tiredness
- Weakness
- Wheezing
- Respiratory infections such as bronchitis and pneumonia that don’t go away or recur
Symptoms of metastatic lung cancer that has spread to other parts of the body may include:
- Bone pain, such as in the back or hips
- Nervous system effects from lung cancer that has metastasized to the brain
- Yellowing of the skin and eyes (jaundice) from cancer spread to the liver
- Swollen lymph nodes such as those in the neck or above the collarbone
What Causes Metastatic Lung Cancer?
The main cause of all types of lung cancer is smoking, which is responsible for 80% of all lung cancer deaths, as well as a number of deaths from exposure to secondhand smoke. Smokers exposed to radon and asbestos are at higher risk.
In non-smokers, causes of lung cancer include:
- Secondhand smoke
- Exposure to radon
- Air pollution
- Workplace exposure to asbestos, diesel exhaust, or other chemicals
- Genetic changes
How Is Metastatic Lung Cancer Diagnosed?
Symptoms of lung cancer often do not appear until the cancer is advanced and has metastasized. For this reason, The American Cancer Society has lung cancer screening guidelines for people with a higher risk of getting lung cancer, such as smokers.
The American Cancer Society recommends people who are 55 to 74 years old, are in fairly good health, are current smokers or who have quit in the past 15 years, and have smoked a certain number of cigarettes per day should receive regular lung cancer screenings. A test called a low-dose CAT scan or CT scan (LDCT) is typically used.
If lung cancer is suspected, imaging tests may be used to diagnose it, such as:
- Chest X-ray
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Positron emission tomography (PET) scan
- Bone scan
Lab tests used to diagnose lung cancer include:
- Sputum cytology
- Thoracentesis
- Tissue biopsy
- Bronchoscopy masses
- Endobronchial ultrasound
- Endoscopic esophageal ultrasound
- Mediastinoscopy and mediastinotomy
- Thoracoscopy
- Lung function tests
- Molecular tests for gene changes
- Tests for certain proteins on tumor cells
- Blood tests
- Complete blood count (CBC)
- Blood chemistry
What Is the Treatment for Metastatic Lung Cancer?
Metastatic lung cancers (stage IV lung cancers) are widespread and very hard to treat and cure. Any of the treatments listed below may be used to help patients live longer, but they are unlikely to cure the disease at this stage.
Treatment for lung cancer depends on the stage, and may include:
- Surgery
- Removal of the tumor (stage 0)
- Removal of the lobe of the lung that has the tumor (lobectomy) or removal of a smaller piece of the lung (sleeve resection, segmentectomy, or wedge resection) (Stage 1)
- Lobectomy or sleeve resection or removal of the entire lung (pneumonectomy) (Stage 2 and later stages)
- Photodynamic therapy (PDT)
- Laser therapy
- Adjuvant chemotherapy
- Radiation therapy
- Radiofrequency ablation (RFA)
- Lymph node removal
- Chemotherapy
- Immunotherapy with pembrolizumab (Keytruda) or durvalumab (Imfinzi)
- Participation in clinical trials
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