Lung cancer with metastases: what to know

Metastatic disease is also called advanced or stage four lung cancer. The spread may involve organs such as the brain, bones, liver, or adrenal glands. Symptoms depend on where cancer is present; brain metastases can cause headaches, weakness, seizures, confusion, or changes in balance. A persistent hoarse voice can have many causes, but it should be assessed in the context of your diagnosis.

Your team may review scans, biopsy findings, and tumour characteristics before recommending a plan. Genomic tumour profiling can identify changes that may guide targeted treatment. The plan can include medicines that travel through the bloodstream, radiotherapy for a troublesome area, or surgery in selected situations. Palliative care can be added at any stage to help with breathlessness, pain, fatigue, appetite, sleep, and emotional strain.

Ask for a written summary of the cancer type, sites involved, test results, and treatment goals. Keep a record of symptoms, medicines, and changes in breathing or activity. Take medicines as prescribed and tell the team about supplements before starting them. Depending on the tumour and your overall health, options may include chemotherapy, radiotherapy, genomic-guided treatment, or a combination. A lung lobectomy is considered only when the disease pattern and fitness make local surgery suitable.

Contact your oncology team promptly for new or worsening breathlessness, chest pain, coughing blood, fever, inability to keep fluids down, or pain that is not controlled. Seek emergency help for sudden weakness on one side, a seizure, severe confusion, rapidly worsening headache, or difficulty speaking. These symptoms can have causes other than cancer, but they need immediate assessment.

Which organs are affected, and what do the scans show? Has genomic tumour profiling been completed? What is the aim of each proposed treatment? How will we judge whether treatment is helping? Which symptoms should trigger a same-day call? Can palliative care, rehabilitation, or emotional support be involved now?