Lung Metastases Imaging: Practice Essentials, Radiography, Computed Tomography
Bone Metastasis In Non-Small Cell Lung Cancer (NSCLC)
NSCLC can spread to almost any part of your body, but it most commonly spreads to bone. Cancer that has spread to bone often has an unfavorable outlook and generally isn't considered curable.
Non-small cell lung cancer (NSCLC) makes up 80% to 85% of lung cancers. It's one of the two main categories of lung cancer, along with small cell lung cancer.
The spread of cancer to distant body parts is known as metastasis. Studies have found that lung cancer is one of the most common causes of bone metastases.
The survival rate for people with lung cancer is highest when the cancer is caught in the early stages, but it's estimated that about 40% of NSCLC cases have spread to distant organs by the time of diagnosis.
In this article, we take a closer look at bone metastasis in NSCLC, including symptoms and how it affects treatment and outlook.
Bone metastasis is the spread of cancer to bone tissue from another organ. Metastatic NSCLC is also referred to as stage 4 NSCLC.
It's estimated that 20% to 30% of people with NSCLC have bone metastases at the time of diagnosis and that an additional 35% to 40% of people develop bone metastases later.
Cancer can metastasize when tumor cells enter your lymph system or blood vessels. Once cancer cells enter these systems, they can spread to almost any part of your body. For people with NSCLC, bone is one of the most common areas of metastasis. Other common areas are:
In a 2017 study, researchers found that adenocarcinoma was the most common type of NSCLC to metastasize. About 40% of lung cancers are adenocarcinomas.
The researchers also found that the ribs were the most common site of bone metastasis, followed by the thorax (the area between your neck and bottom of your rib cage) and the lumbar spine.
People with bone metastasis experience the same symptoms as other people with NSCLC but may also have other specific symptoms, depending on what part of the skeleton the cancer has spread to.
General symptoms of NSCLC include:
Most people with bone metastases develop pain. According to the American Cancer Society (ACS), pain often comes and goes at first and tends to be worse at night. Pain might become more persistent as the cancer progresses.
Other signs and symptoms of bone metastases can include:
Doctors sometimes discover bone metastases through imaging before symptoms develop. Your doctor may order imaging to look for bone metastases if you have symptoms that suggest it.
Many types of imaging can potentially identify bone metastasis. Here are some of the types of imaging you may undergo:
A definitive diagnosis can be made with a bone biopsy, which involves removing a small section of bone tissue for lab analysis. But a doctor may not perform a biopsy if they have a high level of suspicion that the cancer has spread or if performing a biopsy would cause substantial risk.
Your doctor may also order a blood test to look for elevated calcium levels or other markers that suggest the cancer has spread.
NSCLC with bone metastasis is not generally considered curable. Treatment aims to:
Researchers are continuing to examine different treatments for metastatic NSCLC. Current treatment options include:
Doctors rarely surgically remove primary or metastatic tumors in stage 4 NSCLC because surgery has not been shown to prolong overall survival.
NSCLC with bone metastasis is generally associated with an unfavorable outlook, but the outlook is slowly improving over time.
People with bone metastasis often have severe pain, drastically reduced quality of life, and a reduced ability to perform daily tasks. The ACS lists a 5-year relative survival rate of 9% for people with NSCLC that has spread to distant organs.
The median survival time for people with metastatic NSCLC is 14 to 17 months.
In a 2019 study, researchers found some evidence that younger people with bone metastases may have better survival than older people. They found that people under 60 years old lived an average of 11 months, while people over 60 years old lived an average of 8.8 months.
NSCLC can spread to distant organs if cancer cells reach your bloodstream or lymph system. Bone is the most common place for NSCLC to spread.
Metastatic NSCLC tends to have an unfavorable outlook, and treatment generally aims to maximize quality of life and minimize symptoms.
Receiving a cancer diagnosis can be difficult, but your doctor can help you develop the best treatment plan for your specific situation.
Survival rates are slowly improving over time as treatment improves. Your doctor may recommend taking part in a clinical trial that may give you access to treatment that's more effective than the current standard treatments.
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Lung Cancer Is Most Common Cancer To Spread To Brain: Experts
Photo used for illustrative purposes.
Lung cancer is the most common cancer that can spread to the brain and create secondary cancer, said experts on Thursday, on World Lung Cancer Day.
World Lung Cancer Day is observed every year on August 1 to raise awareness around lung cancer -- a leading cause of mortality worldwide.
In India, lung cancer accounts for an annual incidence of 72,510 cases, making up 5.8 per cent of all cancer cases and ranking as the third most commonly diagnosed cancer, according to a recent study published in the journal The Lancet Regional Health.
The health experts noted that a significant challenge arises when lung cancer metastasizes to critical parts of the body, such as the brain.
"Brain metastases are a prevalent complication across various cancer types, particularly among lung cancer patients," Praveen Gupta, Principal Director & Chief of Neurology, Fortis Hospital, told IANS.
"About 10 per cent of newly diagnosed patients with advanced non-small cell lung cancer (NSCLC) develop brain metastases. Lung cancer accounts for 40 to 50 per cent of primary tumours in these cases," he added.
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Addressing brain metastases requires a multidisciplinary approach involving oncologists, neurologists, and palliative care specialists to meet the complex needs of patients.
The primary goals are to alleviate symptoms, extend survival, and enhance the overall quality of life through personalised treatment plans and supportive care.
"Common symptoms of brain metastases include persistent headaches, seizures, cognitive impairments, personality changes, and difficulties with motor functions or speech. These symptoms result from cancerous cells disrupting normal brain function, causing swelling, pressure, and damage to neural pathways," Gupta said.
Lung cancer that has spread to the brain can be treated via therapies such as radiation, and systemic chemotherapy. These interventions aim to manage both the primary lung cancer and brain metastases.
Tobacco smoking is the primary risk factor for lung cancer in India, contributing to a significant proportion of cases.
"Cigarette smoking is the leading cause of lung cancer, responsible for about 85 per cent of all cases. Quitting smoking is the most effective way to reduce the risk," Pavan Yadav, Lead Consultant - Interventional Pulmonology & Lung Transplantation, Aster RV Hospital, told IANS.
"However, exposure to environmental pollutants, occupational hazards, and genetic factors also play crucial roles in the development of this disease," he added.
Early cancer detection and screening, however, play a crucial role in improving lung cancer outcomes.
When lung cancer is diagnosed at an early stage before it has spread to other parts of the body, there is a higher chance of successful treatment and potential cure, Yadav said.
He also recommended screening programmes like Low-dose computed tomography (LDCT) scans for high-risk individuals such as heavy smokers and those with a family history of the disease.
The experts also called to quit smoking and to recognise warning signs "such as persistent cough, chest pain, shortness of breath, hoarseness, unexplained weight loss, and coughing up blood, can prompt individuals to seek medical evaluation if they experience these signs".
Indo-Asian News Service
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