Metastatic disease

Metastatic disease is a process where cancer cells spread from the primary site of origin to distant sites in the body, involving the respiratory system.

• Haematogenous Spread: Via the bloodstream to other parts of the body.
• Lymphatic Spread: Through the lymph system, especially to mediastinal nodes.
• Direct Invasion: Adjacent tissues or organs are invaded by the cancer.

• Renal cell carcinoma.
• Colorectal cancer.
• Breast cancer.
• Testicular cancer.
• Osteosarcoma.

• Asymptomatic (often detected on imaging).
• Cough.
• Dyspnoea.
• Chest pain.
• Haemoptysis.

• Chest X-ray: Multiple round nodules are typical.
• CT scan of the thorax: Better definition of lesions.
• PET scan: Delineate active metabolic areas, suggesting malignancy.
• Biopsy: Confirm diagnosis and identify primary tumour if unknown.

• Systemic therapy: Chemotherapy or targeted therapy based on the primary cancer.
• Radiation: Palliation or directed therapy for limited metastases.
• Surgery: Metastasectomy in selected cases with isolated lung metastases.
• Palliative care: Symptom management and improving quality of life.

• Depends on the primary cancer type, number, and location of metastases, and overall health of the patient.
• Generally poorer than localised disease, but some isolated metastases can be curatively treated.

• Respiratory failure.
• Superior vena cava syndrome.
• Pleural effusion.
• Pneumothorax.
• Infection within necrotic metastatic nodules.

• Regular monitoring and follow-up for patients with known malignancies.
• Early detection and treatment of primary tumours.

• Metastatic disease involves the spread of cancer cells from primary tumour sites to other sites, e.g. lungs.
• Early detection and treatment of primary tumours is crucial to prevent metastatic spread.
• Classical signs such as multiple round nodules are found on imaging.
• Treatment is specific to primary tumour site as well as the severity of metastasis.
• Prognosis is generally poor, but some isolated metastases can be curatively treated.