What should you know about metastatic non-small cell lung cancer?

Non-small cell lung cancer is a group of lung cancers with different cell features and behaviours. Metastatic disease may involve organs such as the brain, liver, bones, or the other lung. Tests can show where the cancer is and which features may guide treatment. Genomic tumour profiling may identify changes that make a targeted medicine suitable. Symptoms depend on the areas affected; breathlessness, chest discomfort, cough, tiredness, or a hoarse voice can occur, but symptoms alone cannot establish the diagnosis.

The outlook is individual. It depends on the cancer subtype, its molecular findings, where it has spread, previous treatment, general health, and how the disease responds. A palliative-care team can help with pain, breathlessness, sleep, mood, and practical support at any stage.

Arrange a review with a medical oncologist or lung cancer team. They may discuss scans, a biopsy, laboratory tests, and genomic tumour profiling before recommending a plan. Options can include targeted therapy, immunotherapy, chemotherapy, radiotherapy for a particular area, or combinations. Surgery such as a lung lobectomy is not suitable for every metastatic situation, but the team may consider local treatment when it fits the overall plan. Bring a medication list, scan reports, and a record of new symptoms. Ask about fertility, work, nutrition, smoking support, and clinical trial suitability if relevant.

Seek urgent medical help for sudden or worsening breathlessness, chest pain, coughing blood, confusion, a seizure, a new severe headache, fainting, or weakness on one side. New difficulty walking, loss of balance, or loss of bladder or bowel control can signal pressure on the spinal cord or spread to the brain and needs prompt assessment. Contact the cancer team quickly if fever, repeated vomiting, dehydration, or rapidly increasing pain develops during treatment.

Which subtype and molecular findings does my biopsy show? Where has the cancer spread, and which scans are still needed? What is the aim of each treatment? How will we judge whether it is helping? Which side effects should prompt a same-day call? Would radiotherapy, chemotherapy, genomic tumour profiling, or palliative care help me now?