Non-small cell lung cancer (NSCLC) is a common type of lung cancer. Metastatic NSCLC refers to later stages of the cancer where it has spread to distant parts of the body.

When NSCLC spreads, it can cause additional symptoms, decrease the likelihood of a positive outlook, and affect treatment.

The following article reviews what NSCLC is, where it can spread, its symptoms, outlook, and more.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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When cancer such as NSCLC spreads beyond the lungs, local tissue, and lymph nodes, it has metastasized. Metastatic refers to the process by which cancer spreads.

There are two ways NSCLC can spread to other areas of the body. These are through the blood and the lymphatic system.

Once cancer has metastasized, there is no cure. Treatment often focuses on prolonging a person’s life and improving their quality of life.

Where does it spread to?

As with other cancers, NSCLC can spread to any site (organ or tissue) in the body. Some sites are more common than others.

According to a 2015 study, the following sites are the most common for NSCLC to spread to:

  • bone – 34.3%
  • lung – 32.1%
  • brain – 28.4%
  • adrenal gland – 16.7%
  • liver – 13.4%
  • extrathoracic lymph – 9.5%

In addition, about 30–40% of all people who receive an NSCLC diagnosis have metastatic cancer.

It is important to note that almost 70% of those included in the study were males, and just over 30% were females.

NSCLC can cause a variety of symptoms, but they are similar to symptoms of any type of lung cancer.

Some common symptoms of NSCLC include:

  • trouble breathing
  • coughing up blood
  • persistent cough
  • cough that gets worse over time
  • unexplained weight loss
  • chest discomfort or pain
  • wheezing
  • trouble breathing
  • hoarseness
  • difficulty swallowing
  • face or neck swelling
  • fatigue

Additional symptoms can occur specific to the area where the cancer has spread. Some additional symptoms a person may experience due to metastasis include the following:

  • Brain: Balance issues, dizziness, or general weakness.
  • Bones: Pain or discomfort in the bones.
  • Liver: Jaundice or yellowing of the skin.
  • Lymph nodes: Swelling of the lymph nodes.

In addition, metastatic NSCLC can cause various paraneoplastic syndromes to occur. These syndromes can appear before other symptoms of the cancer appear, and affect areas of the body the tumor has not spread to.

Paraneoplastic syndromes affect about 10% of all people diagnosed with metastatic NSCLC. Symptoms will vary based on the part of the body or system they affect.

There is currently no cure for metastatic NSCLC. Instead, treatment aims to improve quality of life and increase life expectancy.

According to the American Cancer Society, the 5-year survival rate for metastatic NSCLC is about 7%. This means that 7% of people diagnosed with metastatic NSCLC are still alive 5 years after their diagnosis.

The 5-year survival rate is an estimate used to help give a person an idea of the severity of their condition. Many factors can affect a person’s outlook, including:

  • age
  • activity level
  • overall health
  • smoking status
  • response to treatment
  • genetic factors

Treatment can vary based on where the cancer has spread, a person’s general health, and genes involved in the cancer.

Metastatic NSCLC has no cure and is often more difficult to treat than other stages of the cancer. Treatment tends to focus on prolonging a person’s life and improving their quality of life.

Some common treatment options a doctor may recommend or talk about with a person include:

Each therapy can cause side effects that may make it less appealing. For example, chemotherapy can cause side effects such as:

In some cases, a person and their doctor may decide to stop medical care due to the side effects, particularly if the cancer is not responsive to the treatment option.

People may not receive a diagnosis of NSCL until the cancer has metastasized. Often, early symptoms resemble those of other common conditions, or even the effects of long-term smoking.

Only a small percentage of people receive an early NSCLC diagnosis.

If a person or doctor suspects lung cancer, they will likely order one or more diagnostic tests. They can include:

  • CT, PET, or MRI scans: Imaging tests that can show abnormal growths in or around the lungs or other areas of the body to check for its spread.
  • Biopsy: A biopsy of the lungs can help a doctor determine if any abnormalities are cancerous.
  • Genetic testing: These tests can help show if gene mutations are responsible for the cancer, which could mean the use of targeted therapy for treatment.

Lung cancer can spread at different rates. However, doctors generally consider it a fast-growing and early spreading cancer.

A person’s exposure to risk factors, such as smoking, secondhand smoke, or other pollutants, as well as genetic factors, may play a role in how aggressive the cancer is.

A person should talk with their doctor as soon as they show signs of cancer, particularly if they have known risk factors such as smoking.

Metastatic NSCLC is an advanced form of cancer that has spread from the lungs to other areas of the body. Common areas of spread include the bones, liver, and brain, but it can spread to anywhere in the body.

This stage of NSCLC has no cure and a generally poor outlook. Treatments can help extend a person’s life and help improve their quality of life. A person should talk with their doctor about the treatment options that are best for them.