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Lung metastases

Metastases to the lung; Metastatic cancer to the lung; Lung cancer - metastases

 

Lung metastases are cancerous tumors that start somewhere else in the body and spread to the lungs.

Causes

 

Metastatic tumors in the lungs are cancers that developed at other places in the body (or other parts of the lungs). They then spread through the bloodstream or lymphatic system to the lungs. It is different than lung cancer that starts in the lungs.

Nearly any cancer can spread to the lungs. Common cancers include:

  • Bladder cancer
  • Breast cancer
  • Colon cancer
  • Kidney cancer
  • Melanoma
  • Ovarian cancer
  • Sarcoma
  • Thyroid cancer

 

Symptoms

 

Symptoms may include any of the following:

  • Bloody sputum
  • Chest pain
  • Cough
  • Shortness of breath
  • Weakness
  • Weight loss

In most cases, there are no lung-related symptoms when the tumors are found.

 

Exams and Tests

 

The health care provider will examine you and ask about your medical history and symptoms. Tests that may be done include:

  • Bronchoscopy to view the airways
  • Chest CT scan
  • Chest x-ray
  • Cytologic studies of pleural fluid or sputum
  • Lung needle biopsy
  • Surgery to take a sample of tissue from the lungs (surgical lung biopsy)

 

Treatment

 

Chemotherapy is used to treat metastatic cancer to the lung. Surgery to remove the tumors may be done when any of the following occurs:

  • The first (primary) tumor has been removed
  • The cancer has spread to only limited areas of the lung
  • The lung tumors can be completely removed with surgery

However, the main tumor must be curable, and the person must be strong enough to go through the surgery and recovery.

Less common treatments include:

  • Radiation therapy
  • The placement of stents inside the airways
  • Laser therapy

Experimental treatments may be recommended, such as:

  • Using local heat probes to destroy the area.
  • Placing chemotherapy medicines directly into the artery that supplies blood to the part of the lung containing the tumor.

 

Support Groups

 

You can ease the stress of illness by joining a support group where members share common experiences and problems.

 

Outlook (Prognosis)

 

A cure is unlikely in most cases of cancers that have spread to the lungs. But the outlook depends on the main cancer. Some cancers, such as lymphoma, are very treatable, and even curable. In rare cases, a person can live more than 5 years with metastatic cancer to the lungs.

You and your family may want to start thinking about end-of-life planning, such as:

  • Palliative care
  • Hospice care
  • Advance care directives
  • Health care agents

 

Possible Complications

 

Complications of metastatic tumors in the lungs may include:

  • Fluid between the lung and chest wall (pleural effusion), which can cause shortness of breath or pain when taking a deep breath
  • Further spread of the cancer
  • Side effects of chemotherapy or radiation therapy

 

When to Contact a Medical Professional

 

Call your provider if you have a history of cancer and you develop:

  • Coughing up blood
  • Persistent cough
  • Shortness of breath
  • Unexplained weight loss

 

Prevention

 

Not all cancers can be prevented. However, many can be prevented by:

  • Eating healthy foods
  • Exercising regularly
  • Limiting alcohol consumption
  • Not smoking

 

 

References

Arenberg DA, Pickens A. Metastatic malignant tumors. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 55.

Putnam JB. Lung, chest wall, and mediastinum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 57.

Ripley RT, Rusch VW. Lung metastases. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 52.

 
  • Bronchoscopy

    Bronchoscopy - illustration

    Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.

    Bronchoscopy

    illustration

  • Lung cancer, lateral chest x-ray

    Lung cancer, lateral chest x-ray - illustration

    A lateral view of a chest x-ray in a patient with central cancer of the lung.

    Lung cancer, lateral chest x-ray

    illustration

  • Lung cancer, frontal chest X-ray

    Lung cancer, frontal chest X-ray - illustration

    A chest x-ray in a patient with central cancer of the right lung. Notice the white mass in the middle portion of the right lung (seen on the left side of the picture).

    Lung cancer, frontal chest X-ray

    illustration

  • Coal workers pneumoconiosis - stage II

    Coal workers pneumoconiosis - stage II - illustration

    This chest x-ray shows stage II coal worker's pneumoconiosis (CWP). There are diffuse, small light areas on both sides of the lungs. Other diseases that may explain these x-ray findings include simple silicosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse, infiltrative pulmonary diseases.

    Coal workers pneumoconiosis - stage II

    illustration

  • Coal workers pneumoconiosis - stage II

    Coal workers pneumoconiosis - stage II - illustration

    This chest x-ray shows coal workers pneumoconiosis - stage II. There are diffuse, small (2 to 4 mm each), light areas throughout both lungs. In the right upper lung (seen on the left side of the picture), there is a light area (measuring approximately 2 cm by 4 cm) with poorly defined borders, representing coalescence (merging together) of previously distinct light areas. Diseases which may explain these x-ray findings include simple coal workers pneumoconiosis (CWP) - stage II, silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

    Coal workers pneumoconiosis - stage II

    illustration

  • Coal workers pneumoconiosis, complicated

    Coal workers pneumoconiosis, complicated - illustration

    This picture shows complicated coal workers pneumoconiosis. There are diffuse, small, light areas (3 to 5 mm) in all areas on both sides of the lungs. There are large light areas which run together with poorly defined borders in the upper areas on both sides of the lungs. Diseases which may explain these X-ray findings include complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

    Coal workers pneumoconiosis, complicated

    illustration

  • Coal workers pneumoconiosis, complicated

    Coal workers pneumoconiosis, complicated - illustration

    This picture shows complicated coal workers pneumoconiosis. There are diffuse, massive light areas that run together in the upper and middle parts of both lungs. These are superimposed on a background of small and poorly distinguishable light areas that are diffuse and located in both lungs. Diseases which may explain these x-ray findings include, but are not limited to: complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, and metastatic lung cancer.

    Coal workers pneumoconiosis, complicated

    illustration

  • Pulmonary nodule - front view chest x-ray

    Pulmonary nodule - front view chest x-ray - illustration

    This x-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.

    Pulmonary nodule - front view chest x-ray

    illustration

  • Pulmonary nodule, solitary - CT scan

    Pulmonary nodule, solitary - CT scan - illustration

    This CT scan shows a single lesion (pulmonary nodule) in the right lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.

    Pulmonary nodule, solitary - CT scan

    illustration

  • Sarcoid, stage II - chest X-ray

    Sarcoid, stage II - chest X-ray - illustration

    Sarcoid causes damage to the lung tissue that heals by scarring. The film shows a diffuse milky and granular appearance in the normally dark lung areas. This individual has marked decrease in lung function.

    Sarcoid, stage II - chest X-ray

    illustration

  • Lung with squamous cell cancer - CT scan

    Lung with squamous cell cancer - CT scan - illustration

    This CT scan shows a cross section of the lungs of a person with lung cancer. The two dark areas in the middle of the screen are the lungs. The light areas in the right lung represent the cancer (left side of picture).

    Lung with squamous cell cancer - CT scan

    illustration

  • Respiratory system

    Respiratory system - illustration

    Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

    Respiratory system

    illustration

    • Bronchoscopy

      Bronchoscopy - illustration

      Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.

      Bronchoscopy

      illustration

    • Lung cancer, lateral chest x-ray

      Lung cancer, lateral chest x-ray - illustration

      A lateral view of a chest x-ray in a patient with central cancer of the lung.

      Lung cancer, lateral chest x-ray

      illustration

    • Lung cancer, frontal chest X-ray

      Lung cancer, frontal chest X-ray - illustration

      A chest x-ray in a patient with central cancer of the right lung. Notice the white mass in the middle portion of the right lung (seen on the left side of the picture).

      Lung cancer, frontal chest X-ray

      illustration

    • Coal workers pneumoconiosis - stage II

      Coal workers pneumoconiosis - stage II - illustration

      This chest x-ray shows stage II coal worker's pneumoconiosis (CWP). There are diffuse, small light areas on both sides of the lungs. Other diseases that may explain these x-ray findings include simple silicosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse, infiltrative pulmonary diseases.

      Coal workers pneumoconiosis - stage II

      illustration

    • Coal workers pneumoconiosis - stage II

      Coal workers pneumoconiosis - stage II - illustration

      This chest x-ray shows coal workers pneumoconiosis - stage II. There are diffuse, small (2 to 4 mm each), light areas throughout both lungs. In the right upper lung (seen on the left side of the picture), there is a light area (measuring approximately 2 cm by 4 cm) with poorly defined borders, representing coalescence (merging together) of previously distinct light areas. Diseases which may explain these x-ray findings include simple coal workers pneumoconiosis (CWP) - stage II, silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

      Coal workers pneumoconiosis - stage II

      illustration

    • Coal workers pneumoconiosis, complicated

      Coal workers pneumoconiosis, complicated - illustration

      This picture shows complicated coal workers pneumoconiosis. There are diffuse, small, light areas (3 to 5 mm) in all areas on both sides of the lungs. There are large light areas which run together with poorly defined borders in the upper areas on both sides of the lungs. Diseases which may explain these X-ray findings include complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, disseminated tuberculosis, metastatic lung cancer, and other diffuse infiltrative pulmonary diseases.

      Coal workers pneumoconiosis, complicated

      illustration

    • Coal workers pneumoconiosis, complicated

      Coal workers pneumoconiosis, complicated - illustration

      This picture shows complicated coal workers pneumoconiosis. There are diffuse, massive light areas that run together in the upper and middle parts of both lungs. These are superimposed on a background of small and poorly distinguishable light areas that are diffuse and located in both lungs. Diseases which may explain these x-ray findings include, but are not limited to: complicated coal workers pneumoconiosis (CWP), silico-tuberculosis, and metastatic lung cancer.

      Coal workers pneumoconiosis, complicated

      illustration

    • Pulmonary nodule - front view chest x-ray

      Pulmonary nodule - front view chest x-ray - illustration

      This x-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.

      Pulmonary nodule - front view chest x-ray

      illustration

    • Pulmonary nodule, solitary - CT scan

      Pulmonary nodule, solitary - CT scan - illustration

      This CT scan shows a single lesion (pulmonary nodule) in the right lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.

      Pulmonary nodule, solitary - CT scan

      illustration

    • Sarcoid, stage II - chest X-ray

      Sarcoid, stage II - chest X-ray - illustration

      Sarcoid causes damage to the lung tissue that heals by scarring. The film shows a diffuse milky and granular appearance in the normally dark lung areas. This individual has marked decrease in lung function.

      Sarcoid, stage II - chest X-ray

      illustration

    • Lung with squamous cell cancer - CT scan

      Lung with squamous cell cancer - CT scan - illustration

      This CT scan shows a cross section of the lungs of a person with lung cancer. The two dark areas in the middle of the screen are the lungs. The light areas in the right lung represent the cancer (left side of picture).

      Lung with squamous cell cancer - CT scan

      illustration

    • Respiratory system

      Respiratory system - illustration

      Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.

      Respiratory system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Lung metastases

           

             

            Review Date: 5/20/2016

            Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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