Lung cancer can spread to nearly any region of the body, but the most common areas are the adrenal glands, bones, brain, liver, and lymph nodes.
Lung Cancer Spread to the Adrenal Glands
Lung cancer spread to the adrenal glands (small glands that sit on top of the kidneys and produce hormones), does not usually cause any symptoms, and is most often discovered incidentally when a scan is done to stage cancer.
Treatment with chemotherapy for the cancer may be helpful. In a very small number of people who were able to have their lung cancer removed and had only one spot in one of the adrenal glands, surgery to remove the adrenal gland and adrenal metastases has resulted in long-term survival.
Lung Cancer Spread to the Bones
Roughly 30 to 40% of people with advanced lung cancer have spread (metastases) to bones. The most common bones to be affected are the spine (especially the vertebrae in the chest and lower abdominal area), the pelvis, and the upper bones of the arms and legs (humerus and femur). Lung cancer is also somewhat unique in that it can spread to the hands and feet.
The most common symptom of bone metastases is pain. Often the pain begins gradually, feeling like a muscle pull or strain, and progresses to more severe pain. Due to weakening of the bone from the tumor, some people develop fractures (pathological fractures) that occur with minimal trauma or even during normal daily activities.
If lung cancer spreads to the spine, it may put pressure on the spinal cord (spinal cord compression). This may cause weakness or tingling in your legs or difficulty walking. Cancers that metastasize to bone may also breakdown bone releasing calcium into the blood (hypercalcemia) causing symptoms of confusion, muscle weakness, and loss of appetite among others.
Tests to look for bone metastases may include a bone scan, PET scan, CT or MRI. The primary goal of treatment of bone metastases is to reduce pain and to repair or prevent fractures that occur. Options include pain medication, radiation therapy, medications to try to prevent the breakdown of bone, and surgery to stabilize bones.
Lung Cancer Spread to the Brain
Lung cancer is the most common cancer that spreads to the brain, and at least 40% of people with advanced lung cancer will develop brain metastases sometime during their disease. Both non-small cell lung cancer and small cell lung cancer can spread to the brain. Small cell lung cancer can spread to the brain rapidly, often before a diagnosis is even made. Prophylactic cranial irradiation (PCI), a type of radiation therapy, may be used to attempt to prevent this from occurring.
Lung cancer that has spread to the brain can cause symptoms both by destroying brain tissue, and by creating inflammation and swelling that places pressure on structures in the brain. In roughly a third of people, no symptoms are present.
Common symptoms can include headaches, seizures, loss of balance and coordination, difficulty with speaking, vision changes, loss of memory and personality changes, weakness on one side of the body, and fatigue. Lung cancer metastatic to the brain is usually diagnosed with either a CT scan or an MRI of the brain.
Lung Cancer Spread to the Liver
Lung cancer that has spread to the liver may not cause any symptoms, and is often discovered when a test, such as a CT scan, are done to look for spread of your cancer. When symptoms are present, they may include pain under your ribs on the right side of your body, loss of appetite, and nausea. If there are many tumors in your liver or if the metastases are large enough to obstruct ducts in your liver, you may develop jaundice (a yellow coloring of your skin and the whites of your eyes).
Tests that are done to look for spread of lung cancer to the liver may include an abdominal ultrasound, a CT scan of your abdomen, or a PET scan.
Treatment is usually chemotherapy designed to treat the primary cancer as well. In rare cases if only a single tumor or a few tumors are present, surgery may be recommended to remove the tumors. Sometimes a procedure called embolization may be recommended as well. This is a procedure that stops the blood flow to part of the liver so cancer cells that are present can’t survive.
Lung Cancer Spread to the Lymph Nodes
Most lung cancers first spread to lymph nodes in the chest near the tumor. As cancer progresses, cancer cells can travel to areas in the chest further from the initial tumor, and then on to other regions of the body.
Most of the time, spread of lung cancer to the lymph nodes doesn’t cause any symptoms. When these cancers extend to lymph nodes beyond the lungs, you may notice a lump in your neck or your armpit, similar (but usually firmer) to the swollen glands you may have had in the past with a sore throat.
Treatment is usually chemotherapy, unless the lymph nodes that are involved are near the initial tumor and can be removed with surgery.
While the regions above are the most common sites for lung cancer metastases, lung cancer has on occasion spread to the stomach, small and large intestines, the pancreas, the eye, the skin, the kidney, and even the breast.