Metastatic lung cancer is also called advanced lung cancer.
Symptoms of advanced cancer can be difficult to cope with. But doctors and nurses can offer support and treatment to help you.
Treatments such as chemotherapy, radiotherapy or targeted cancer drugs can help to shrink the cancer, reduce symptoms and help you feel better.
You might get one or more of the following symptoms:
Tiredness (fatigue) is a common symptom of advanced cancer. You may feel that you lack energy, and this can be overwhelming.
Let your doctor or nurse know if you’re very tired, as they can prescribe medicine to help or other treatments to help. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).
It’s important to rest a few times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help.
Exercising can be hard when you feel very tired. But, research shows that daily light to moderate exercise can give you more energy. You can try a short walk if you can manage it. Gentle exercises in bed or standing up can help if you can’t move around easily.
Your hospital physiotherapist might be able to help you plan an exercise programme that suits your needs.
You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.
You might have pain in the area of the cancer but not everyone does. Painkillers can usually control pain well.
There are many different painkillers and ways of taking them. Your doctor and nurse can help you to be pain free most of the time.
You and your friends or relatives can do things to help reduce the pain. Complementary therapies such as relaxation and massage may help.
Cancer can sometimes make you short of breath due to fluid that collects between the two layers that cover the lungs. This collection of fluid is called a pleural effusion.
Fluid around the lungs can be uncomfortable, but a doctor can drain the fluid to make you more comfortable.
You might feel very breathless if the cancer is blocking your airway. This can be distressing. Doctors can use treatments to remove some of the blockage to help you feel less breathless. And you can learn breathing techniques to help.
You might notice that your face, neck or arms are swollen. This might be because the tumour is blocking a large vein in your chest. This is called superior vena cava obstruction (SVCO).
Other symptoms of SVCO include:
- swollen veins in your neck
- dizziness and vision changes
Treatments for SVCO include:
- putting a tube called a stent into the vein to keep it open
Swallowing can be difficult and painful if you have advanced lung cancer. This might make it hard to get enough nutrition. And you might find you are losing weight.
Your dietitian can help you. They can advise you on a soft diet or nourishing drinks you can sip.
Treatments such as chemotherapy, radiotherapy or laser therapy can sometimes shrink the cancer. Then you can swallow more easily.
Other possible symptoms
Other symptoms depend on where the cancer has spread to:
If your cancer has spread to the liver, you might have a swollen tummy (abdomen). The swelling is due to a build up of fluid called ascites. It can make your clothes feel tighter. You might have tummy pain or feel bloated. You might also find it difficult to sit comfortably or to move around. Some people feel breathless.
Your doctor can drain off the fluid by putting a small, flexible tube into the abdomen. This helps you to feel more comfortable.
You might have bone pain if your lung cancer has spread to your bone. Your bones might be weaker, so they could break more easily.
- medicines called bisphosphonates
- radiofrequency ablation
Cancer that has spread into the spinal bones can cause pressure on the spinal cord. This is called spinal cord compression. The pressure on the spinal cord stops the nerves from working normally. This can cause:
- back pain
- changes in sensation, such as tingling or numbness
- changes in the way your bowel or bladder work
- difficulty walking
You might have any of the following symptoms if your cancer has spread to your brain:
- memory problems, mood or personality changes
- severe headaches, often with sickness
- weakness of an arm or leg
If lung cancer has spread to the layer lining the brain, you might have one or more of the following symptoms;
- double vision
- leaking urine (incontinence) due to a build up of fluid in the brain
Symptoms can usually be well controlled.
Your doctor or specialist nurse can help you. They can
- give you medicines
- get equipment that you need
- suggest other ways of controlling your symptoms
- tell you about things that you or your friends and family can do
- refer you to a symptom control team (a palliative care team)
Symptom control team
Members of the team are experts at controlling symptoms. They can help you to stay as well as possible for as long as possible. There are symptom control teams in most cancer units. They are also in hospices and many general hospitals.
Most symptom control teams have home care services who can visit you at home.
Towards the end of life
It’s natural to want to find out what is likely to happen in the last few weeks or days of life.
You might need to choose where you want to be looked after and who you want to care for you.