The clinical relevance of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in chronic obstructive ...
What To Know About Metastatic Endometrial Cancer
Metastatic endometrial cancer can affect distant areas of the body, such as the lungs, liver, bones, or brain. Treatments may include surgery alongside radiation therapy, chemotherapy, or other drugs.
Metastatic endometrial cancer is an advanced stage of cancer that has spread from the lining of the uterus to other areas of the body.
Symptoms of advanced endometrial cancer may include pelvic pain, a mass in the pelvis, and unexplained weight loss.
This article examines where metastatic endometrial cancer may spread, treatment options, and outlook.
Metastatic endometrial cancer is cancer that begins in the endometrium, the lining of the uterus, and spreads to a distant part of the body.
Doctors stage endometrial cancer from 1 to 4, with higher numbers indicating the cancer has spread further from the original site.
Stage 4 cancer means it has spread to other areas of the body.
Learn more about the stages of cancer.
According to a 2019 analysis, the most common site for endometrial cancer to spread to is the lungs. After this, other common sites are distant lymph nodes, the liver, bones, and the brain.
According to a 2023 review article of 3,878 people with metastatic endometrial cancer, distant organ metastasis is rare. The article found that rates of distant organ metastasis were as follows:
Stage 4 endometrial cancer includes cancer that has spread to the following areas:
Learn more about what happens when cancer spreads to the lymph nodes.
According to the American Cancer Society (ACS), some symptoms of endometrial cancer can be more common as the cancer progresses. People may notice the following:
If cancer has spread to another part of the body, people may also experience symptoms relating to that part of the body, such as:
These symptoms can also occur with other health conditions, but it is always best to speak with a doctor as soon as possible if people notice any new or worsening symptoms.
Learn more about some of the symptoms of endometrial cancer.
Surgery is typically the first-line treatment for endometrial cancer. This includes a hysterectomy to remove the uterus, as well as removal of the fallopian tubes and ovaries. People may also have surgery to remove lymph nodes in the pelvic area.
In metastatic endometrial cancer, the cancer has usually spread too far for surgery to remove all of the cancer. People may still have surgery but will have other additional treatments to help destroy cancer cells. This may include:
Hormone therapy may be effective for some types of endometrial cancer, but certain types may not respond to this particular treatment. This may include high grade cancers and cancer cells with no detectable progesterone and estrogen receptors.
People may have a combination of some of the following chemotherapy drugs:
Targeted drugs and immunotherapy are also options for treating advanced stages of endometrial cancer.
People with metastatic endometrial cancer may also want to consider joining clinical trials that are testing new treatments.
Learn more about some common types of chemo drugs.
The outlook for metastatic endometrial cancer may depend on which part of the body the cancer has spread to. According to a 2020 report, the outlook may be poor for people with endometrial cancer that has spread to the brain or multiple organs.
A 2019 analysis found that endometrial cancer that spread only to the distant lymph nodes had the best overall survival, while cancer that spread to the brain had the worst outlook compared to other areas of metastasis.
According to a 2023 review article, in cases where endometrial cancer spread to one distant organ, the longest survival time occurred with lung metastasis, while the shortest survival occurred with brain metastasis.
Other factors that can affect a person's outlook include age, overall health, and treatment response.
What is the survival rate for metastatic endometrial cancer?According to the National Cancer Institute, the 5-year relative survival rate for endometrial cancer, which has spread to distant areas of the body, such as the lungs, liver, or bones, is 18.9%.
As medical research and treatments advance, outlook and survival rates for endometrial cancer may improve from previous reports.
What is the life expectancy of metastatic endometrial cancer?Life expectancy can depend on:
A 2020 study looked at how surgery affected life expectancy in 730 people with metastatic endometrial cancer.
The average cancer-specific survival for people with lung metastasis was 23 months with surgery and 9 months without surgery.
For bone metastasis, survival was 19 months with surgery and 8 months without surgery, and for multiple organ metastasis, survival was 15 months with surgery and 4 months without surgery.
Life expectancy for brain metastasis was 6 months with or without surgery.
Learn more about cancer prognoses.
People may find the following resources helpful:
Where is the first place endometrial cancer spreads?Endometrial cancer may first spread to areas surrounding the lining of the uterus. In stage 1 endometrial cancer, it may grow into the myometrium, which is the outer layer of the uterus.
What is the most aggressive endometrial cancer?Low-grade type 1 endometrioid cancers are generally less aggressive, as they may stay within the uterus and may have a favorable outlook.
High-grade type 2 endometrioid and non-endometrioid cancers with TP53 gene mutations may spread and reach an advanced stage with a less favorable outlook.
How fast does endometrial cancer spread?The type of endometrial cancer may affect how quickly it spreads. The most common form of endometrial cancer is type 1, which is slow-growing. Type 1 endometrial cancer does not usually spread outside the uterus.
Type 2 endometrial cancer grows more quickly and is more likely to spread outside the uterus to other areas of the body.
Metastatic endometrial cancer is cancer that starts in the lining of the uterus but has spread to distant areas of the body, such as the lungs, bones, or distant lymph nodes.
Treatment for metastatic cancer may include surgery alongside other treatments, such as radiation therapy, chemotherapy, hormone therapy, or other cancer drugs.
The outlook for metastatic endometrial cancer may depend on treatment, the subtype of endometrial cancer, and which area of the body it has spread to.
Stage 4 Lung Cancer
Medically reviewed by Gagandeep Brar, MDMedically reviewed by Gagandeep Brar, MD
Lung cancer is a type of cancer that grows in your lung tissue. Stages of cancer span from 0-4, with stage 4 being the most advanced stage of lung cancer. Lung cancer is often diagnosed in the later stages because symptoms may be difficult to detect before stage 3 or 4. There are two main types of lung cancer—small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
Small cell lung cancer (SCLC) makes up about 10-15% of all lung cancer cases, and non-small cell lung cancer (NSCLC) makes up about 80-85% of lung cancer cases. SCLC tends to spread more rapidly beyond the lungs to other parts of the body.
Lung cancer is the leading cause of cancer-related death in the United States. However, more research is being done every day to advance treatment and detect lung cancer sooner. Your healthcare team will create a treatment plan based on how advanced your cancer is. Treatment options for stage 4 lung cancer include chemotherapy, radiation therapy, and immunotherapy.
How Is Stage 4 Lung Cancer Characterized?An oncologist (a doctor who specializes in the diagnosis and treatment of cancer) will perform several tests to determine what stage, or how advanced, your cancer is. Knowing the stage of cancer helps them develop an effective treatment plan.
The American Joint Committee on Cancer (AJCC) developed the TNM staging system to determine how advanced cancer is. The system is broken down into three factors:
T for tumor: Measures the size and location of a cancerous tumor
N for nodes: Determines if cancer cells have spread to the lymph nodes (a group of glands part of the immune system)
M for metastasis: Assesses if cancer cells have spread (metastasized) beyond the lungs to other areas of the body
The less advanced stages of lung cancer are stages 0-3. Stage 4 lung cancer means the cancer has spread to other parts of the body.
There are two types of stage 4 lung cancer: stage 4A and stage 4B. Stage 4A usually means the cancer has spread to the chest, both lungs, the lining around your lungs (pleura), and the lining around your heart (pericardium). Stage 4B means the cancer has spread to one or more tumors outside of your chest or to other lymph nodes and organs.
Both non-small cell lung cancer and small-cell lung cancer use the same staging system, though the system is generally not as important in SCLC. Instead, the cancer might be considered to be in a limited stage (cancer is only on one side of your chest) or an extensive stage (cancer has spread to other parts of your body).
CausesStage 4 lung cancer develops when cancer cells from the lung spread to other parts of the body. The cancer cells can move in several ways, including growing into nearby tissue and passing through lymph node or blood vessel walls.
Lung cancer is most commonly caused by smoking tobacco. Smoking is linked to 80% of lung cancer deaths in the U.S. Smoking cigars or menthol cigarettes and using chewing tobacco can also cause lung cancer.
It is rare to be diagnosed with lung cancer if you have never smoked, but it's possible. Exposure to secondhand smoke, air pollution, and diesel exhaust can also cause lung cancer.
Risk FactorsThere are several environmental and lifestyle risk factors for lung cancer. Depending on the environment you live or work in, you may be able to alter some of the following risk factors:
Secondhand smoke: Being physically close to someone who is smoking increases your risk of lung cancer over time.
Radon exposure: Radon is a radioactive gas found in soil and rocks. Consider conducting a radon test in your home to check for exposure.
Asbestos exposure: People who work in mines, textile plants, and shipyards are at increased risk for asbestos exposure. Asbestos is a chemical commonly used to create commercial and industrial products.
Exposure to chemicals: Inhaling chemicals such as arsenic, beryllium, or diesel exhaust in work environments increases your risk of lung cancer.
Beta-carotene supplements: People with a history of heavy smoking may have an increased risk of lung cancer if they take beta-carotene (a compound that gives plants their color) supplements.
Radiation therapy: If you have received radiation therapy for another type of cancer, it may raise your risk of lung cancer.
Air pollution: People who live in cities with more air pollution with more exposure to things like diesel exhaust from cars are more likely to develop lung cancer.
Family history: If one of your family members has been diagnosed with lung cancer, your risk is higher.
With stage 4 lung cancer, you can experience the symptoms of lung cancer that people with less advanced stages might experience, as well as symptoms in other parts of your body based on where the cancer has spread.
Common symptoms of lung cancer include:
A bad cough
Hoarse voice
Chest pain
The presence of blood when you cough
Loss of appetite
Unintended weight loss
Shortness of breath
Wheezing
Tiredness or weakness
Chronic (long-term or repeated) respiratory infections like bronchitis and pneumonia
Because stage 4 lung cancer affects other parts of the body, you may also experience:
Bone pain, such as in your back or hips
Yellowing of the skin and eyes (jaundice), if the cancer has spread to the liver
Swollen lymph nodes in the neck or above the collarbone
Headache, weakness or numbness in your arm or leg, dizziness, balance issues, seizures, and other nervous system changes if the cancer has spread to the brain
Lung cancer can also cause syndromes as it spreads. For instance, cancer that spreads to nerves in the face can lead to Horner syndrome, which causes eyelid drooping. Other conditions that may occur include superior vena cava syndrome (cancerous tumors that grow in the upper right lung) and paraneoplastic syndrome (a group of syndromes that can affect organs that lung cancer cells have not yet spread to).
DiagnosisSeveral tests help diagnose stage 4 lung cancer. When you develop symptoms of lung cancer, your healthcare provider will likely start by performing a physical exam and asking about your medical history. They will ask questions about the symptoms you are experiencing and any risk factors, such as smoking history.
Diagnostic tests for lung cancer include:
Blood tests: A complete blood count (CBC) can measure blood cells and tumor markers.
Sputum markers: A test of saliva and phlegm can detect tumor markers.
Lung biopsy: A small sample of lung tissue is taken and sent to a lab to be tested for cancer cells.
Bronchoscopy: A healthcare provider inserts a tubed camera into the lungs to look for signs of cancer.
Chest X-ray: Images of the lungs and chest cavity can identify abnormalities like tumors.
Magnetic resonance imaging (MRI) scan: This test uses strong magnets to take X-ray pictures of the lungs at several angles.
Computed tomography (CT) scan: This radiation test can locate the lung tumor and determine its size. People with a history of heavy smoking may benefit from regular lung cancer screenings with a low-dose CT scan.
Positron emission tomography (PET) scan: This nuclear scan locates cancer cells throughout your body and determines how far lung cancer has spread.
Several treatment options are available, but stage 4 lung cancer can be hard to cure. Your healthcare provider will discuss the ultimate goal of treatment, which may be to help prolong your life or to let you live more comfortably in the time you have left. The treatment plan will depend on how much your cancer has spread and which areas of the body are affected.
Stage 4 NSCLC: Treatment may include a combination of surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, photodynamic therapy, and laser therapy.
Stage 4A: If the cancer has spread to just one other location, you might have surgery and radiation on the secondary location before treating the cancer in the lung.
Stage 4B: If the cancer is more widespread, your treatment may begin with genetic testing. Tumors that test positive for certain gene mutations may have to receive targeted therapy (treatment that uses drugs to target specific molecules).
Stage 4B NSCLC: If you have high levels of the PD-L1 protein, your healthcare provider may recommend immunotherapy. Immunotherapy drugs boost the immune response to cancer cells, which can attack the PD-L1 protein in cancerous tumors.
Targeted therapy and immunotherapy may be given with chemotherapy (cancer cell-killing drugs are injected into your vein).
Treatment for stage 4 SCLC typically does not include surgery or radiation, as they are usually ineffective. Chemotherapy and immunotherapy may improve your symptoms and prolong your life. If your symptoms are breathing-related, radiation may help improve your symptoms.
Palliative CareWith stage 4 lung cancer, it is not uncommon for the cancer to return even after a period of remission (symptoms of your cancer go away). Palliative care is a type of treatment that focuses on extending and improving your quality of life. The goal of palliative care is not to cure cancer but to ease the burden of symptoms from treatment.
Palliative care is different from hospice or end-of-life care. This is supportive care that aims to improve symptoms and reduce pain or discomfort. Palliative care varies from person to person, depending on the toll the cancer takes on your body.
Your healthcare provider may prescribe pain medications and anti-nausea medications to reduce symptoms related to the cancer and cancer treatments. If one of your symptoms is difficulty breathing, you may be given airway support and oxygen to open your airways and improve breathing.
Experiencing cancer often affects your mental health. A solid support system is important throughout the treatment process. For this reason, your healthcare team may add emotional support and counseling to your palliative care.
Stage 4 Lung Cancer PrognosisMost cases of stage 4 lung cancer are not curable. Your prognosis (how the cancer will behave in your body over time) depends on several factors:
The type of lung cancer you are living with
How the cancer is spreading
Your age
Your overall health before being diagnosed
How your body responds to treatment
When predicting outcomes, your healthcare team will consider the five-year survival rate. This estimates the percentage of people who will survive five years after diagnosis. The five-year survival rate is 9% for NSCLC and 3% for SCLC.
PreventionPreventing all lung cancer cases may not be possible, but you can take steps to lower your risk. Although it can be challenging, quitting smoking can reduce your chances of developing lung cancer later in life. The risk of lung cancer can decrease 30-60% after 10 years of quitting smoking. For long-term smokers, it is also important to not take beta-carotene supplements.
Check with your healthcare provider right away if you are experiencing common symptoms of lung cancer.
A Quick ReviewBeing diagnosed with stage 4 lung cancer can be a scary experience. A big part of living with stage 4 lung cancer is the palliative care you receive as you go through the treatment process. This can vary depending on multiple factors, including the type of lung cancer you are living with, your age, and how your cancer is progressing.
Treatment for stage 4 lung cancer can be mentally taxing. Reach out to your healthcare provider or a loved one for emotional and mental health support if it is not already a part of your treatment plan. Although not many people with stage 4 lung cancer live for long, there are treatments available to extend your life.
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Doctors Told A 29-year-old She Had Anxiety And That She Was 'too Young For Cancer.' She Had Stage 4 Kidney Cancer.
Katie Coleman knew something was wrong: She had high blood pressure and a racing heart, despite being 29 years old with no previous health issues.
But over the course of a year and a half, doctor after doctor — eight in total — told her she had anxiety, and continued to put her on anti-anxiety meds. "Two doctors told me I was too young for cancer when I asked. It made me feel like a hypochondriac," Coleman, a software developer in Austin, Texas, told Today.Com.
Coleman tried to solve the problem herself by losing 50 pounds by walking daily and eating well. That's when she a mass on her abdomen became prevalent. "The best way that I can describe it is it felt like I had six-pack abs on that side, but I don't have a six-pack in any way, shape, or form," Coleman said.
After a nurse at an urgent care clinic encouraged her to go the ER, Coleman underwent an ultrasound and CT scan in December 2020. The tests revealed an almost 5-inch mass on her kidney and several tumors in her liver, she told Today.
She was diagnosed with a rare type of renal cell carcinoma, which had spread to her liver, deeming it stage 4.
"I almost felt a sense of relief because for once, I had somebody sitting across from me who believed me and there was a reason for why I had been feeling terrible," she said.
After a couple months of treatment that Coleman doesn't specify, she underwent surgery six months after the diagnosis. The procedure is typically reserved for earlier-stage cancers. Doctors took out her right kidney and pieces of her liver. They also burned off some liver tumors, she said.
Now, nearly a year after the first procedure, Coleman's liver is being monitored. She doesn't know her prognosis given the rarity of the disease.
"Today, I'm feeling great," she said. "I actually feel the best I've felt in my entire life, which is really weird to say with stage 4 cancer. I'm very appreciative for however long a period of time I get to feel this way."
Research shows women are among the most vulnerable to what is often called medical gaslighting, or when medical professionals dismiss a person's symptoms, deny tests or treatments, and ultimately misdiagnose them.
"They're not being believed, and that's causing significant delays in care, misdiagnosis, late diagnosis, ineffective treatment, and ineffective triaging," Dr. Garima Sharma, a cardiologist at Johns Hopkins, previously told Insider. "Women are paying a very heavy price."
While Coleman said she doesn't blame the doctors for not catching her disease earlier, other young women have spoken out about the consequences of not being taken seriously.
Georgia Ford, a 20-year-old law student in the UK, said her heartburn-like symptoms were chalked up to alcohol misuse. She was later diagnosed with an incurable cancer.
Wakisha Stewart was also told her crushing pain and nausea was anxiety at age 31; she really had a type of heart attack most common in new moms.
"I want the medical community to start opening up their eyes and not accusing women or misdiagnosing women as having panic attacks or anxiety attacks, because it could be more," Stewart told Insider.
Some studies have found women patients tend to wait longer for cancer and heart disease diagnoses than men. One study showed that younger women were two times more likely than young men to have a medical expert give a mental-health diagnosis when their symptoms pointed more to heart disease.
Sharma encourages her fellow medical professionals to trust women's concerns — regardless of, or perhaps because of — their lack of apparent risk factors.
"The fact that they are in the ER at that time means that they're so worried about their symptoms that they're ready to drop everything that's more important to them," she said. "If a young woman comes in and is really saying, 'this does not feel right,' they need to believe her."
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