Secondary cancer in the lung | Cancer Research UK
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Secondary cancer in the lung

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This page tells you about cancer that has spread to the lung from another part of the body. This is called secondary lung cancer. There is information about

 

A quick guide to what’s on this page

Where a cancer starts is called the primary cancer. If some cells break away from the primary cancer and move to another part of the body they can form another tumour – a secondary cancer. Cancer that has spread into the lung from another part of the body is called a secondary lung cancer.

Symptoms of secondary lung cancer include

  • A cough that doesn’t go away
  • Shortness of breath
  • Chest infections
  • Weight loss
  • A build up of fluid between the chest wall and the lung (a pleural effusion)

Tests for secondary lung cancer may include a chest X-ray and CT scan.

The aim of treatment depends on the type of primary cancer you have. For some types the aim may be to try and cure the secondary cancer. But for others the aim may be to control the cancer and symptoms for some time. Deciding about treatment can be difficult when you have an advanced cancer. You need to understand what treatment can do for you. You may also want to think about your quality of life during treatment.

Treatment may include one or more of the following

Coping with a secondary lung cancer can be difficult. Finding out that you have secondary cancer is likely to bring up many feelings. You may be frightened, angry, shocked or numb. Support to help you cope is available at the hospital, from your GP and specialist nurses, and from support groups or online forums.

Research is going on all the time into improving treatments for secondary lung cancer and helping people to cope with symptoms. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

 

Secondary lung cancer

Where a cancer starts is called the primary cancer. If some cells break away from the primary cancer, they can move through the bloodstream or lymph system and spread to another part of the body, where they can form a new tumour. This is called a secondary cancer. Secondary cancers are also called metastases (pronounced met-ass-ta-sees).

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The secondary cancer is made of the same type of cells as the primary cancer. So, for example, if your cancer started in your bowel, the bowel cells have first become cancerous, then spread from the bowel tumour and formed another tumour in your lung. This matters because the primary cancer tells your doctor which type of treatment you need.

This page has information about secondary lung cancer, its treatment, and how to cope, including where you can get help and support.

 

Having secondary cancer

Finding out that your cancer has spread is likely to bring up many different feelings. You may be frightened, angry, shocked or numb or all of these. Most people have already had treatment for a primary cancer and it can feel very unfair to have to cope with cancer a second time. Some people have a secondary cancer when they are first diagnosed.

Finding out about your cancer and your treatment options can help you to feel more in control and better able to cope. Try to give yourself time. It is usually easier to deal with one issue at a time rather than trying to sort everything out at once.

You will need to get information from your own specialist to understand what the diagnosis means for you. It depends on where the cancer first started and whether it has spread anywhere else. Your specialist can also tell you about treatment and how it may help.

 

Which cancers spread to the lungs

Any cancer can spread to the lung. But the most common cancers to do so are

  •  Breast cancer
  •  Bowel cancer
  •  Kidney cancer
  •  Testicular cancer
  •  Bladder cancer
  •  Melanoma skin cancer
  •  Bone cancer
  •  Soft tissue sarcomas
 

Symptoms of secondary lung cancer

Sometimes secondary cancers in the lung are picked up before they cause symptoms, during tests to diagnose the primary cancer. Or rarely, the first symptom you have could be from a secondary lung cancer.

Symptoms may include

  • A cough that doesn’t go away
  • Shortness of breath
  • Ongoing chest infections
  • Weight loss
  • Coughing up blood
  • A build up of fluid between the chest wall and the lung (a pleural effusion)

pleural_effusion

Fluid may build up because cancer cells can inflame the sheets of tissue that cover the lungs (the pleura or pleural membranes). The inflamed tissues make extra fluid, which collects between them. This fluid builds up and stops the lungs from expanding fully when you breathe in. A pleural effusion can cause shortness of breath, chest aching, discomfort and heaviness.

These symptoms can also be due to other more common conditions such as a chest infection. If you have any of them tell your doctor so that they can check them out.

 

Tests for secondary lung cancer

A chest X-ray is usually the first test you have. You may also have a CT scan. These tests diagnose secondary lung cancer and can also show any build up of fluid around the lungs (pleural effusion).

 

Treatment for secondary lung cancer

The aim of treatment depends on what type of primary cancer you have had. For some cancers, the aim may be to cure your cancer. For other types of cancer the aim may be to control your cancer and symptoms. This is called palliative treatment.

As well as the type of primary cancer, your treatment will depend on a number of factors including

  • The treatment you have already had
  • The size and number of secondary cancers in your lungs
  • Whether your cancer has spread to other parts of the body
  • Your general health

Deciding about treatment

Deciding about treatment can be difficult when you have advanced cancer. You need to understand what treatment can do for you. You may also want to think about your quality of life while you are having treatment. All treatment will have some side effects. You also need to consider other factors such as travelling to and from hospital. If you start treatment, you can stop whenever you want to if you are finding it too much to cope with.

Your doctor will be able to talk this through with you and you can ask questions. You may also find it helpful to talk things over with a close relative or friend. Or there may be a specialist nurse or counsellor at the hospital you can talk to.

Types of treatment

Treatment for cancer that has spread to the lung may include one or more of the following.

Chemotherapy

Chemotherapy uses cell killing drugs to kill the cancer cells.

Your doctor may suggest chemotherapy for cancer that has spread to the lungs. The type of chemotherapy you have will depend on your type of primary cancer. You can find out more in the chemotherapy section for your type of cancer. You can also read our general information about chemotherapy.

For some types of primary cancer, such as testicular cancer and Hodgkin lymphoma, the aim of chemotherapy may be to cure the cancer. For other cancer types the treatment aims to help control the growth of your cancer and reduce symptoms.

You have chemotherapy as a liquid into a vein in your arm, or as tablets or capsules. If the first type of chemotherapy you have (called 1st line treatment) does not control your cancer, you can usually have a different type of chemotherapy (2nd line treatment).

Hormone therapy

Some cancers depend on hormones to survive and grow. So lowering hormone levels in the body, or stopping hormones reaching cancer cells, can help to control them. This includes breast and prostate cancers. You may have hormone treatment for other types of cancer that have spread to the lung.

Hormone treatment may be tablets or injections. We have general information about hormone therapy. You can also read about hormone therapy for your type of cancer in our cancer types section.

Biological therapy

Biological therapies are treatments that act on processes in cells. Or they may stop cells telling each other to divide and grow. They can slow or stop the growth of a cancer for some time. Your doctor may suggest biological therapy if it is suitable for your particular type of cancer. There are many different types of biological therapy, including monoclonal antibodies and cancer growth blockers.

Find out about biological therapies. You can check whether biological therapies are suitable for your type of primary cancer in our section about your cancer type.    

Radiotherapy

Radiotherapy uses high energy rays similar to X-rays to kill cancer cells. It can help to control symptoms such as shortness of breath, a cough, pain, or coughing up blood. Treatment helps to shrink the tumour and control symptoms, but it can’t cure your cancer.

You usually have the radiotherapy from an external machine. The photograph shows an external radiotherapy machine.

A photo of a linear accelerator, which gives radiotherapy

Some people have internal radiotherapy (brachytherapy or endobronchial therapy) given from inside the lung airway. It is sometimes used when a tumour is blocking, or partly blocking, your airway. Internal radiotherapy can shrink the blockage to help make your breathing easier. It can also help to control any infection or bleeding caused by the tumour.

Surgery

Some people can have surgery to remove secondary lung cancers. It depends on where your cancer started. The aim of this type of surgery is to cure the cancer. From research we know that surgery to remove secondary lung tumours can work for cancers that started in the bone or for soft tissue sarcomas. It is not usually suitable for other types of cancer, such as breast cancer or prostate cancer. Researchers are looking into it for bowel cancer that has spread to the lungs. Surgery is not usually an option if your cancer has spread anywhere else in your body.

Other factors that your doctor takes into account include

  • Where the secondary tumours are in your lungs
  • The size of the secondary tumours
  • How many secondaries you have
  • How well your doctor expects your lungs to work after surgery
  • Whether you have any other health conditions

If you have surgery you may have chemotherapy or biological therapy before or after the operation.

Surgery to remove lung tumours is a major operation so you need to be generally fit and well enough to have surgery. Your doctor will talk to you about exactly what the operation involves in your particular case.

Radiofrequency ablation (RFA)

Radiofrequency ablation (RFA) kills cancer cells by heating them up. You need to go to a specialist centre to have this treatment.

Find out about radiofrequency ablation.

Symptom control

The treatments above can help to control symptoms by shrinking or removing the lung tumours. But if symptoms are still a problem, there are other ways of controlling them. The symptoms listed here are the most common ones that people have with secondary lung cancer. 

Shortness of breath

Shortness of breath can be frightening. There are number of things that can help.

The treatment you need will depend on the cause of your shortness of breath. You may have

  • Oxygen therapy
  • Medicines  to open your airways (nebulisers)
  • Laser treatment
  • A small tube (stent) put in if your cancer is blocking your airway

Find out about these and other treatments for breathing problems.

You can help yourself by practicing breathing control exercises. These can help you to cope when you become short of breath and can make it less frightening. Look at our tips and a video about exercises to help with shortness of breath.

Fluid on the lung (pleural effusion)

Some people develop fluid around the lung. This is called a pleural effusion. It can cause shortness of breath. Your doctor may be able to drain the fluid and give you treatment to stop it building up again. They call this pleurodesis.

Read about draining fluid from the lung.

Cough

If you have a cough, radiotherapy can help to reduce it. Your doctor or nurse can also prescribe medicines to help.

Other symptoms

You may also have more general symptoms such as tiredness, pain, difficulty swallowing and loss of appetite. The coping physically section has information about these common symptoms and how to cope with them.

 

Coping with secondary cancer

There is no set way of dealing with cancer that has spread. Support is available at the hospital and from cancer support groups. Getting the support you need can help you to cope. Your hospital or cancer organisations can offer emotional support or practical help, such as dealing with money matters.

It is important that you feel as well as you possibly can. Ask your specialist, GP or hospital nurse about referral to a symptom control nurse (sometimes called palliative care nurses or home care nurses). These specialist nurses can work with you and your doctor to help control your cancer symptoms and help you to feel better.

Most people are worried about their outlook (prognosis) when they have a secondary cancer. It is very difficult to say what will happen. Only your own doctors can guide you, as they have all the information about your cancer. Even then, they can only give you a general idea. Your individual outlook depends on many factors including whether the cancer has spread to more than one part of your body, how quickly it is growing, and how it responds to treatment.

Your doctor may have told you that treatment is no longer working or is not possible. This can be a shock. It is likely that you will have all sorts of questions that are difficult to ask and also difficult to answer.

Common questions include

  • How long do I have to live?
  • How will I die?
  • Will I have pain?
  • What will happen to me?

It may help to write your questions down before you talk to your doctor or nurse. Or you can contact the Cancer Research UK information nurses to talk your questions and worries through with them. The number is freephone 0808 800 4040 and the lines are open from 9am to 5pm, Monday to Friday.

It is common in any family for some people to want to ask difficult questions and some not. It can help to respect this and give each other space to ask as much as you want to. This may mean that you need to give your doctor permission to talk to your next of kin or other family members alone. Or if you are a relative you may need to give the person with cancer the space to talk to the doctor on their own.

Our section about dying with cancer has information about coping with the news of a secondary cancer. It also discusses the help and support available to you and your family.

 

Research into secondary lung cancer

Research is going on all the time into improving treatments for secondary lung cancer and helping people to cope with symptoms. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

Find out about clinical trials.

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Updated: 18 May 2015