Symptoms of metastatic lung cancer

Metastatic lung cancer means that the cancer has spread from where it started in the lung. It is also called advanced lung cancer.

It might not mean that you have advanced cancer if you have the symptoms described below. They can be caused by other conditions.

General symptoms

Possible symptoms of lung cancer are:

• a new cough or a cough most of the time
• breathlessness
• unexplained weight loss
• ongoing chest infections
• coughing up blood
• a hoarse voice
• difficulty swallowing
• changes in the shape of your fingers and nails called finger clubbing
• swelling of the face caused by a blockage of a main blood vessel (superior vena cava obstruction)
• a loss of appetite
• tiredness and weakness

Your doctor might carry out routine blood tests and find that you have a raised platelet count (thrombocytosis). This might be a sign of lung cancer but could also be due to other illnesses or conditions.

Lung cancer can also sometimes cause a build up of fluid between the two layers covering the lung (a pleural effusion). This can cause a cough and breathlessness.

Breathlessness

You may feel very breathless if the cancer is blocking your airway or if there is fluid around your lung.

Where lung cancer can spread

Other symptoms of metastatic lung cancer depend on where the cancer is in the body. Lung cancer can spread to:

• the lymph nodes nearby or distant lymph nodes

• the brain

• the liver

• the bones

• the adrenal glands

• other parts of the lung or the other lung

Symptoms if lung cancer has spread to the lymph nodes

Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fight infection.

The most common symptom if cancer has spread to the lymph nodes is that they are usually bigger than normal. But lymph nodes 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.

Tell your doctor if you find any lumps or swollen areas, particularly in your neck or armpits.

Symptoms if lung cancer has spread to the brain

Cancer that has spread to the brain might cause any of the following symptoms:

• memory problems, mood or personality changes
• seizures
• confusion
• severe headaches, often with sickness
• weakness of an arm or leg

Symptoms if lung cancer has spread to the liver

You might have any of the following symptoms if your cancer has spread to the liver:

• discomfort or pain on the right side of your tummy (abdomen)
• feeling sick
• poor appetite and weight loss
• a swollen tummy (called ascites)
• yellowing of the skin and whites of the eyes (jaundice)
• itchy skin

Symptoms if lung cancer has spread to the bone

Cancer that has spread to the bone can cause:

• pain (this can be lower back pain if the cancer cells are in the spinal bones)

• weaker bones (they may get damaged or break more easily)

• raised calcium levels in your blood (causing dehydration and confusion)

If you have these symptoms, you may have a PET-CT scan or a bone scan.

If cancer cells in the spinal bones are pressing on the spinal cord (spinal cord compression) it can cause:

• weakness in your legs

• numbness

• loss of bladder or bowel control

Symptoms if lung cancer has spread to the adrenal glands

The adrenal glands are small glands just above the kidney.

Cancer that has spread to the adrenal glands doesn’t usually cause any symptoms.

The adrenal glands produce hormones and if cancer has spread to both adrenal glands you might have low levels of adrenal hormones. This might cause:

• loss of appetite
• weight loss
• nausea
• tummy (abdominal) pain
• weakness
• changes to substances in your blood

Other rare symptoms

Some people have swollen fingers and nails, and pain and swelling in their joints. This condition is called hypertrophic pulmonary osteoarthropathy (HPOA).

Controlling symptoms

Treatments such as radiotherapy or chemotherapy can sometimes shrink the cancer and reduce symptoms.

You might also have treatment with a targeted drug or immunotherapy.

Symptom control team

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.