Metastatic Lung Cancer Treatment

Medical oncologist Everett E. Vokes, MD, in an internationally known expert in lung cancer treatment and serves as UChicago Medicine's physician-in-chief and chair of the Department of Medicine.

A diagnosis of metastatic, or stage 4, lung cancer can be frightening. It means the lung cancer has spread outside the initial location in the lung to another body part(s).

Patients and their loved ones need to know that treatments for metastatic lung cancer have advanced dramatically in recent decades. There are new targeted drugs and immunotherapies, improved radiation technologies, and less invasive surgeries.

In addition, cancer experts at the UChicago Medicine Comprehensive Cancer Center discovered that certain metastatic cancers — known as oligometastatic cancers — can be controlled for longer periods of time with more aggressive treatment approaches. In rare cases, these cancers can be cured.

“Oligometastatic” means the cancer has spread to a limited number of sites. Our lung cancer physicians currently treat oligometastatic lung cancer with targeted radiation and/or surgery in addition to drug therapies. They are also conducting clinical trials to determine whether patients with more advanced metastatic lung cancers would benefit from similar treatment regimens.

Thanks to these forward-thinking innovations, patients with metastatic lung cancer — both non-small and small cell lung cancers — are living longer than they did 10 years ago. We are optimistic that research at UChicago Medicine and elsewhere will ensure that more patients with metastatic lung cancer can soon look forward to even longer lives.

Our lung cancer team also places great emphasis on helping to ensure our patients have the quality of life that they desire during and after treatment. UChicago Medicine offers a wide range of treatments and supportive services to help prevent or relieve pain, breathing difficulties and other symptoms.

Frequently Asked Questions About Metastatic Lung Cancer

Where does metastatic lung cancer typically spread?

What are the symptoms of metastatic lung cancer?

The lungs do not have pain receptors. For this reason, many people have no symptoms when lung cancer is limited to the lungs. As a result, many lung cancer patients are diagnosed after the disease has metastasized, or spread to another area of the body.

Symptoms of metastatic lung cancer depend on where the disease has spread. For instance, bone pain (such as hip pain) is common if lung cancer spreads to the bones. When cancer spreads to the brain, symptoms might include vision changes, headaches, dizziness or weakness in an arm or leg.

The lymph nodes, such as those in the neck, may also be swollen when lung cancer metastasizes.

If another type of cancer, such as breast or liver cancer, spreads to the lungs is it considered lung cancer?

What is oligometastatic lung cancer and how is it diagnosed?

“Oligometastasis” is Greek for “a few that spread.” Oligometastatic lung cancer is defined loosely as lung cancer that has spread to a limited number of sites in the body. Typically, this means five or fewer sites, but can mean as many as 10 or more sites.

UChicago Medicine’s Limited Metastatic Cancer Program is internationally renown for advancing the diagnosis and treatment of oligometastatic cancers, including lung cancer. Many patients are adding years to their lives with treatment regimens designed to curtail the spread of cancer. In rare cases, these treatments offer a cure.

Our cancer experts determine on a case-by-case basis whether a patient’s lung cancer can be classified as oligometastatic. In general, we look at the overall burden of disease in addition to the number of sites that lung cancer has spread to. For example, a patient might be diagnosed with oligometastatic lung cancer if her cancer has spread to seven sites but with small amounts of cancer in each site. At the same time, another patient with only three sites of spread but with large amounts of cancer in one of the sites might also be diagnosed as oligometastatic cancer.

Other factors may also be considered when diagnosing oligometastatic lung cancer, including a previous history of cancer, the pace at which the cancer is spreading, and overall health.

Our cancer team may order various tests to assist in making a diagnosis, including imaging exams and a biopsy (the removal of a small amount of cancerous tissue).

How is metastatic lung cancer treated?

A variety of factors influence how our lung cancer team treats each patient’s metastatic lung cancer. Each patient’s treatment plan is designed to obtain the best possible outcomes for that patient, taking into account the specific cancer diagnosis, how advanced the cancer is, and the patient’s personal preferences.

When a patient is diagnosed with oligometastatic lung cancer, we often recommend a combination of two or more treatments:

Drug Therapy

Three types of drug therapies are used to treat lung cancer:

Targeted drug therapy, which is prescribed when laboratory tests identify a treatable genetic mutation in cancer cells. A number of new targeted therapies have been introduced in recent years, including ones that target HER2 lung cancers. Most targeted drug therapies are oral medicines (pills) but some are given via an IV.
Immunotherapy, or drugs that help the body’s immune system fight cancer.
Chemotherapy, or drugs that fight or kill cancer cells.

Radiation Therapy

Surgical Options

Advanced Metastatic Lung Cancer

When a patient’s lung cancer is more advanced, our goals are to help patients live as long and as well as possible. We may recommend drug therapy to shrink the tumors, which can help improve quality of life and extend life.

Surgery is not typically performed in late-stage lung cancer. However, radiation may be used to shrink tumors with the goal of relieving symptoms and improving quality of life.

What sets UChicago Medicine apart in the treatment of metastatic lung cancer?

We offer an extensive clinical trial portfolio, which provides our lung cancer patients with access to leading-edge treatments that are not commonly available elsewhere. For example, we conduct clinical trials on new targeted medications for specific genetic mutations that cause lung cancer. In addition, we continue to explore how to best diagnose and treat oligometastatic disease, with the goal of further improving patient outcomes.

Our lung cancer specialists believe in a team approach to diagnosing and treating cancer. This means that all of our experienced cancer specialists — which includes medical oncologists, radiation oncologists, thoracic surgeons, pathologists, radiologists, nurses and others — are involved in each case, combining their deep expertise to determine how to best treat the cancer.

In addition, our dedicated supportive oncology program provides a range of supportive care services to patients and their families, including mental health counseling, social work services and more. Our patients have access to many other supportive services, including:

Nurse practitioners who will help you navigate your cancer treatment
Nutritionists to help maintain a healthy diet
Pain control experts
Tobacco cessation support

Treating Metastatic Cancer with Optimism and Hope

If you have been diagnosed with metastatic cancer, more therapies may be available to you than you think. Our cancer specialists are eager to help you understand all of your options.

Limited Metastatic Cancer Program

Request an Appointment

We are currently experiencing a high volume of inquiries, leading to delayed response times. For faster assistance, please call 1-855-702-8222 to schedule your appointment.

If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.

For Referring Physicians

To refer a patient for lung cancer care, please call UCM Physician Connect at 1-800-824-2282.

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Everett Vokes, MD, in lung cancer tumor board meeting

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