What advanced lung cancer is

Advanced (or metastatic) lung cancer means the cancer has spread from where it started in the lung. A cancer may be advanced when it is first diagnosed. Or the cancer may come back some time after you are first treated (recurrent cancer).

Lung cancer can spread locally into nearby structures – for example, it may grow into an airway, the chest wall or the lining of the lung (the pleura). You can find more information about the stages of lung cancer in this section.

Specialists regard a lung cancer as advanced if you have fluid collecting around the lung and the fluid contains cancer cells. This situation is called a pleural effusion. There is information about treating pleural effusion on the treatment for advanced lung cancer page.

A cancer that has spread to another part of the body is called a secondary cancer or metastasis. Some of the lung cancer cells have travelled through the lymphatic system or bloodstream and lodged in another part of the body. The cells have then started to grow there. See the what is cancer page for information about how this happens.

Not all lung cancers will spread. But if the cancer does spread there are certain parts of the body that it is more likely to go to. The most common areas for lung cancer to spread to are

• The lymph nodes within the chest, or in the abdomen, neck, or armpit
• The liver
• The bones
• The brain
• The adrenal glands

We have included the most likely symptoms of cancer spread below because this is one of the things people most often ask for. But these symptoms can also sometimes be caused by other things. A symptom is most likely to be caused by cancer if it lasts for a couple of weeks. Cancer symptoms don't usually come and go. Let your doctor know if you have any symptoms that last for more than a few days or are getting worse.

Lymph nodes

Lymph nodes containing cancer are usually bigger than normal. If you find any lumps in your neck or armpit, do tell your doctor. Lymph nodes do also get bigger if you have an infection. So you can't be sure of the cause of a lump until your doctor has examined you and done some tests.

Liver

Cancer spread to the liver may cause pain in your right side, just under your ribs. Or you may feel sick, particularly after eating rich food. A later symptom is often jaundice, where the whites of your eyes and your skin may look a bit yellow. Your doctor can use a blood test to check how well your liver is working. You may also have an abdominal ultrasound.

Bones

If you have cancer cells in the bone, this is most likely to show up as pain. The cancer cells weaken the bone and sometimes a fracture is the first sign. It is most likely to be diagnosed on an X-ray or after a bone scan. Treatment can help to control the pain and may strengthen the bone.

Brain

Cancer spread to the brain may make you drowsy and confused. Or you may have severe headaches, often with sickness. Cancer in the brain is most often treated with radiotherapy, together with steroid tablets, to control symptoms. It is most likely to be diagnosed with a brain scan, either a CT scan or an MRI scan.

Adrenal glands

Cancer that has spread to the adrenal glands does not usually cause symptoms. The adrenal glands are hormone producing glands on top of the kidneys. But your level of adrenal hormones may get very low if both adrenal glands contain cancer cells. Low levels of these hormones may cause faintness, dizziness, weakness, tiredness and weight loss. Some people may also have stomach aches. Adrenal gland secondaries usually show up on a CT scan or ultrasound scan. 

Remember that you may sometimes get aches and pains that are not related to the cancer. But do check with your doctor about any symptom that worries you. Your doctor will be able to help.

You can phone the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.

Our lung cancer organisations page has details of people who can give information about advanced lung cancer and its treatment. Some organisations can put you in touch with a cancer support group. Our lung cancer reading list has information about books and leaflets on lung cancer treatments.

You can ask your doctor or specialist nurse to write down the names of your treatments so that you can look them up. We have detailed information about cancer drugs in our cancer drugs section.