Lung metastasis consists of the cells of a tumor that has developed in a region of the body and spreads to the lungs.
Malignant tumors consist of millions of cells.
Some leave the primary tumor and spread through the bloodstream or lymphatic system to other parts of the body, in this case the lungs.
Origin of metastases and affected organs
1. It can develop in the lungs (primary lung tumor).
2. It can spread from the primary tumor in another area of the body to the lungs. This is known as a secondary tumor or lung metastasis.
A lung tumor can also form metastases in other organs. Most affected are:
Lung metastases are caused by tumors in the third or fourth stage.
Tumors that cause lung metastases include:
- Large intestine (colon and rectum)
- Breast (mammary gland carcinoma)
- Kidneys (renal carcinoma)
- Uterus (leiomyosarcoma)
- Malignant melanoma, a skin tumor
- Osteosarcoma (a type of cancer of the skeletal system), can also spread to the lungs.
Metastases can form in many organs, but the liver and lungs are particularly affected because they are heavily supplied with blood.
Lung metastases can:
- occur unilaterally and affect only one lung,
- bilatereal and affect both lungs (right and left).
If metastases occur multiply, the clinical picture is more serious than if they occur individually.
How do they make themselves felt? Signs and symptoms of lung metastases
Often symptoms of secondary tumors are painful and include:
- cough that does not pass;
- Cough with bloody tinged sputum;
- Weight and appetite loss;
- respiratory insufficiency;
- persistent and unpleasant chest pain.
Many of these symptoms are similar to those of the primary lung tumor.
They are often caused by diseases other than cancer, for example by an infection in the thoracic area.
If any of these symptoms occur, a doctor should be consulted.
The doctor may suspect lung metastasis if:
- a tumour has already been diagnosed,
- some of these symptoms occur, especially if they do not respond to any therapy (for example, antibiotics).
Sometimes metastases are diagnosed before the primary tumor.
Occasionally, it is not possible to identify the original tumor. This means then: in case of unknown primary tumor.
Possible complications of lung metastases
- Fluid accumulation in the pericardium (pericardial effusion) can cause pain that spreads to the chest, arm, hand, and lead to shortness of breath.
- Fluid accumulation between the pleural leaves and in the thorax (pleural effusion), which can lead to shortness of breath.
- Increased tumor spread.
- Side effects of chemotherapy and radiotherapy.
Diagnosis of lung metastases
As a rule, lung metastases are diagnosed during examinations and controls performed as part of the primary tumor, for example:
- X-ray (X-ray horax) to show the size and location of the cancerous tumor.
- CT (computed tomography). The X-rays are used to display three-dimensional images of the inside of the body.
The scan is painless and takes 10-15 minutes.
CT uses only a small proportion of X-rays.
This examination is more accurate than the X-ray.
- Positron emission tomography (PET). Use of a radioactively enriched sugar of low concentration to measure the activity of the cells in the different areas of the body. The reason for this is that tumor cells consume much more sugar than the cells in the environment. A small amount of the slightly radiolabeled sugar, usually fluorodeoxyglucose (FDG for short), is injected into the arm via a vein. The scan takes place a few hours later.
- Biopsy. Sometimes sampling from the tissue may be required. This is usually done in the X-ray department and under CT control. The biopsy is performed under local anesthesia to numb the area. Then a cannula is inserted to remove a small piece of tissue.
After that, the sample excision is examined under the microscope. The biopsy can be uncomfortable, but it only takes a few minutes.
Treatment of lung metastases
Treatment of lung metastases depends on:
- the individual situation,
- the general state of health,
- the type of primary tumor.
Sometimes combination therapy is used.
Metastases are operable only in a few cases.
The possibility exists only if the primary tumor is known and there is no evidence of spread to other parts of the body. In addition, the tumor may be used for surgical intervention:
- affect only a small part of the lungs,
- be easily accessible,
- is not connected to important blood vessels or nerves.
One can do a short cycle of radiation therapy to relieve some symptoms of the secondary lung tumor, such as:
- shortness of breath,
- Coughing up blood (hemoptosis).
A special form of internal radiotherapy (brachytherapy) called endobronchial radiation therapy can be performed when a airway is blocked.
Procedure of brachytherapy:
- With the help of a bronchoscope, a thin tube (catheter) containing radioactive material is placed near the tumor.
- This remains in place for a few minutes so that the rays can destroy the tumor.
- The catheter is then removed again.
In most cases, only one session is required.
Laser therapy If the tumor has caused a displacement of the trachea or the large airways, laser therapy
can be used to reduce the tumor. This can alleviate some symptoms, even if the cancer is not completely destroyed.
If the tumor causes pressure on the nearby structures of the trachea, a small tube called a stent can be inserted to keep the bronchi and trachea open. The stent can remain permanently in the trachea or bronchi. It usually does not cause any discomfort.
Chemotherapy is often used to reduce and control the secondary tumor in the lungs. What kind of chemotherapy drug doctors prescribe depends on:
- whether it has already been administered,
- from the duration of treatment.
Hormone therapy Hormone therapy
can be used to treat lung metastases resulting from hormone-sensitive neoplasms, such as:
- breast cancer,
- Prostate cancer.
The type of hormone therapy depends on which hormone treatments have already been done.
Treatment of symptoms of lung metastases
The symptoms of a pulmonary secondary tumor can interfere with a patient’s daily life and be painful.
of breath This is a common and worrying problem that affects all areas of life. It can be alleviated by:
- some muscle-relaxing exercises.
The doctor may prescribe oxygen therapy to relieve shortness of breath.
Lung metastases can lead to water accumulation between the two membranes (pleura) surrounding the lungs.
This is called pleural effusion.
The fluid puts pressure on the lungs and can V:
- dull pain.
These symptoms can be reduced by carefully draining the fluid through a tube. This procedure is called pleural cavity drainage and is carried out as follows:
- The doctor injects a local anesthetic to numb the area.
- The tube is inserted into the chest between two lower ribs.
- Drainage is left for 2-3 days.
The pleural effusion can recur, then doctors sometimes perform pleurodesis (as in the case of pneumothorax).
This operation serves to unite the outer and inner pleural layer, i.e. the pleura.
This surgical procedure can be performed under general anesthesia to achieve a better result.
Cough and chest pain They can usually be relieved by medications prescribed by the doctor, such as painkillers such as acetaminophen.
Fear of suffocation People with shortness of breath may be afraid of choking.
However, it is very unlikely that this will happen.
Coughing up blood (hemoptosis)
Often some blood admixtures are observed in the sputum of patients with lung metastases.
If a large proportion of blood is detected, the doctor must be informed to determine the special therapy (such as radiation therapy).
How long do you live? Survival and life expectancy of a patient with pulmonary mastasis
In most cases, the cure is unlikely.
The 5-year survival rate is rare.
Nevertheless, life expectancy depends on the special doctor of the primary tumor.
For the prognosis, it is important to know whether the patient also:
- bone metastases,
- liver metastas,
- has metastases in other organs.
In some serious cases, there is no meaningful treatment and doctors administer palliative therapy (solely for symptom relief).