Cancer that begins in other parts of the body can sometimes spread to the lung(s).
Our 'Living well with advanced cancer' booklet is available now.
What is advanced cancer?
Advanced cancer (also called secondary cancer or metastatic cancer) is cancer that has spread from the part of the body where it started, (the primary cancer) to another part of the body.
Although the cancer is growing in a different part of the body, it is still named after the primary cancer. For example, if breast cancer has spread to the lungs, it is called advanced breast cancer.
Advanced cancer that has spread to the lung(s)
Cancer that begins in another part of the body, can sometimes spread to the lung(s).
This is called advanced cancer that has spread to the lung.
Your treatment team may use different words to describe cancer that has spread to the lung.
You may hear it called:
- metastatic lung cancer (lung mets)
- secondary lung cancer
- stage 4 (IV) cancer.
Symptoms of cancer that has spread to the lung(s)
Having any of the following symptoms does not always mean that cancer has spread to the lung, but it is important to get any changes checked by your GP or whānau doctor.
Signs that cancer may have spread to the lung include:
- A cough that doesn’t go away
- Feeling short of breath or wheezy at rest
- A chest infection that doesn’t improve with treatment, or frequent chest infections
- Chest, upper back or shoulder pain that does not go away
- Coughing up blood (haemoptysis)
- Weight loss for no reason, or loss of appetite
- Feeling very tired
Finding out if cancer has spread to the lung(s)
If your GP or whānau doctor is concerned that any symptoms you may be experiencing could be caused by cancer that has spread to the lung(s), they will recommend further tests (investigations).
These tests may include:
Your doctor will listen to your chest to hear how well you are breathing.
A chest x-ray is usually the first test done to try to find out what is causing symptoms like a cough and shortness of breath. An x-ray will show cancers 1cm or larger.
A CT scan creates a 3D picture of the inside of your body. It can show smaller cancers than an x-ray.
An MRI uses magnets and radio waves to make a detailed picture of the inside of your body.
A PET-CT scan uses a radioactive dye injected into your arm that will show up in areas affected by cancer. You may have to travel to a different hospital for this scan.
A bronchoscopy uses a thin, flexible tube called a bronchoscope, to look at the inside of the breathing tubes and lungs. It is often done to find out why a person is coughing up blood. A biopsy can be taken during a bronchoscopy.
A biopsy takes a small sample of the abnormal cells to check if they contain cancer.
Managing cancer that has spread to the lung
Cancer that has spread to the lung is often managed with more than one type of treatment.
Your treatment may include:
- Hormone treatment – most commonly used in cancer that has spread from the breast or prostate
- Radiation treatment
- Specialist palliative care
- Supportive care
- Targeted treatments
- Thoracentesis, pleurodesis and/or indwelling pleural drain - to manage pleural effusion
- Traditional healing or complementary therapy
The goals of any treatments are to control the cancer for as long as possible, improve any symptoms you may be experiencing, and to maintain your quality of life.
Sometimes treatments for cancer, such as radiation or chemotherapy, may no longer work, but you will always benefit from supportive care.
Supportive care includes the management of physical symptoms, emotional and spiritual support, and guidance to help you plan for the future.
Supportive care will mostly be provided by your primary health care team, Cancer Society support workers, and specialist palliative care services.
If the symptoms you are experiencing are difficult to manage, you and your whānau may be referred to a specialist palliative care service.
Specialist palliative care helps with the physical and emotional needs of people with advanced cancer and can link you with practical support in your local area. Care can be provided at home or in a hospital, rest home, or hospice by doctors, nurses, social workers, spiritual care workers, and cultural health services.
Breathlessness (also called shortness of breath, or dyspnoea) is a common problem in people with cancer that has spread to the lung(s).
Your doctor may do some tests to check why you are short of breath, so that they can help you to manage your symptoms.
Living well with advanced cancer
Looking for ways to stay as well possible can help reduce stress and improve your wellbeing.
The following suggestions may be helpful:
- Eating well, keeping active and relaxing can help your overall health and improve sleep.
- Keeping in touch with whānau and friends can be an important support. You may choose to keep working if you can - talk to your employer about reduced hours or lighter duties if you need.
- Some people find that prayer or talking to a spiritual advisor/tohunga is a way to find strength and meaning in times of stress.
- Setting goals for things you have wanted to do but have not yet had the chance can give a sense of structure and purpose.
Learning to manage uncertainty is another important part of staying healthy.
These tips may help:
- It is important to ask for support. Talk with your treatment team about support and resources available to help you if you are struggling.
- Accept that there are things you can control and things you cannot.
- Talk to the Cancer Society or your GP/whānau doctor about counselling services.
- Try a local support group or talk with a social worker at the hospital.
- Talk with family/whānau and friends. Tell them how you are feeling and how they can help.
- Learn as much as you can about the cancer and its treatment. Having the right information can help you know what to expect.
- Maintain your usual interests, friendships, and activities that give you time out from cancer.