Non-small cell lung cancer that has metastasized may cause different symptoms depending on where it has spread. Treatment can help reduce symptoms and prolong life.

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. Although metastatic NSCLC isn’t curable, it’s still possible to enjoy a strong quality of life.

This article examines metastatic NSCLC, how it’s treated, and the outlook for people with it.

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:

  • bones
  • lungs
  • brain
  • liver
  • adrenal glands

Approximately 47.3% of people with NSCLC present with distant metastases at the time of diagnosis.

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.

Without metastasis

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
  • hoarseness
  • shortness of breath
  • fatigue or weakness
  • infections like bronchitis and pneumonia that keep recurring or don’t go away
  • new wheezing

With metastasis

If 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 the neck or near the collarbone

Sometimes, lung cancer 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.

Treatment for NSCLC that has metastasized depends 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: 65%
  • regional: 37%
  • distant: 9%
  • all stages combined: 28%

These numbers are based on people who have received a diagnosis of NSCLC between 2012 and 2018.

These are not definitive survival rates, and everyone is different. These statistics 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

What factors affect the spread of non-small cell lung cancer?

Research has found that lung cancer is particularly adept at metastasizing to a wide range of organs, even in its early stages. The following characteristics of lung cancer help enable this spread:

  • Hypoxia resilience. Lung cancer tumor tissue is able to withstand low oxygen levels.
  • Immune system immunity. Lung cancer cells are able to fend off immune system attacks.
  • Cell migration. Rather than remaining in one place, lung cancer tumor cells make changes to themselves so they can migrate to other places in the body via the bloodstream.
  • Organ colonization. Lung cancer cells are distinctive from other types of cancer in that they can metastasize to a wide range of organs, including the brain, bone, liver, and respiratory system.

What stage is metastatic non-small cell lung cancer?

Metastatic NSCLC is the most advanced form of NSCLC, or stage 4. In this stage, the cancer has spread to the lining of the lung or to other distant areas of the body.

How long can you live with metastatic non-small cell lung cancer?

According to the American Cancer Society, the 5-year relative survival rate for metastatic NSCLC is about 9%. If the cancer has only spread to nearby tissue, the rate improves to 37%.

It’s worth noting that these numbers are based on people who’ve received a diagnosis of NSCLC between 2012 and 2018. Advancements in treatment have improved survival rates for people with metastatic NSCLC. These new treatments include:

  • combination chemotherapy
  • targeted therapies such as EGFR (epidermal growth factor receptor) therapy
  • immunotherapy

How curable is metastatic non-small cell lung cancer?

Metastatic NSCLC isn’t typically curable, but new treatments have enabled people with this type and stage of lung cancer to enjoy a longer and better quality of life.

Talk with your doctor about your individual outlook and treatment plans.

When NSCLC spreads to other areas of the body, it is metastatic cancer.

Although metastatic NSCLC is rarely curable, treatments are available that can help relieve symptoms, prolong 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 side effects.