Stage 4 Cancer Symptoms For Lung, Breast, Colon Cancer etc.

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So, to start with. If you are looking for stage 4 cancer you must be having an idea of what is cancer. If told in one line, cancer is uncontrolled proliferation of cells in the body. It may be from any site or organ of body. For example if the cells of breast tissue start to divide uncontrollably, it may lead to breast cancer, but not so easily. Today, in this article we will stage 4 cancer symptoms for various types including Lung, Breast, and others listed below.

Many checkpoints are there by the body’s defense system due to which even if uncontrolled growth happens in a cell or a group of cells, it may be halted at further steps. Only after evading multiple checkpoints, a cell becomes cancerous. Now even if cancer develops in an individual, it may be in early stages and if detected on time, may be controlled or cured completely.

But sometimes, cancer cells migrate from their original site and and travel through blood to get lodged at other sites of the body. This is called as metastatic disease or stage 4 cancer.

The symptoms of metastatic disease will depend on the site of metastasis and obviously on the site of origin. Depending on the site of metastasis, the symptoms of stage 4 cancer may be as follows-

Lung Metastasis

It may be the involvement of lung parenchyma or pleural membrane, leading to pleural effusion. It may cause symptoms such as cough, breathlessness, chest pain, etc. Lung metastasis are more commonly multiple than single, and bilateral than unilateral.

Diagnostic investigations to pickup lung metastasis is X ray chest, and more specifically Ct scan of chest, where they appear as ground glass opacities. However, other causes must be ruled out like tuberculosis, primary lung malignancy, infections, sarcoidosis, etc. Lung metastasis is mostly seen from breast cancer, GI cancers, osteosarcoma, etc.

Liver Metastasis

Liver is also a common site of metastasis from other organs. Liver involvement by cancer spread may cause symptoms like jaundice, right upper abdominal discomfort, abdominal distention, etc. Liver function test may also be deranged with raised bilirubin, alkaline phosphatase, GGT, etc. Liver metastasis are also multiple more commonly than solitary and may involve both lobes of liver.

Other causes like hemangioma, cysts, or other benign lesions should be ruled out, and CT scan of abdomen is helpful for this. Hepatocellular carcinoma of liver also causes liver lesions and triple phase CT scan of abdomen is helpful for diagnosing that. Serum alfa fetoprotein (AFP) may be elevated in cases of liver involvement. Biopsy from the liver lesion is helpful in confirming the diagnosis. Most common primary sites for liver metastasis are colon, gall bladder, pancreas, ovary, breast, lung, etc.

Brain Metastasis

Spread of cancer to brain may lead to symptoms depending on site of brain involvement, size and number of metastasis. Most common symptoms are headache, vomiting or nausea, mental changes, memory problems, seizures, and/or dizziness. They are more common located in the watershed arterial zone at grey white matter junction. Usually there is a zone of peritumoural oedema out of proportion with the tumour size. Other lesions like tuberculosis, abscesses, toxoplasmosis, fungal infections, etc may present as brain SOLs and should be ruled out. MRI of brain should be done if we are suspecting brain metastasis in an individual. Most common primary lesions leading to brain metastasis are cancers of lung, breast, colon, kidney and melanoma.

Bone Metastasis

Spread of cancer to bone may lead to pain, fracture from minor trauma, spinal cord compression leading to lower limb weakness, urinary incontinence, bowel incontinence etc. Any bone may be involved but most commonly affected are spine, pelvis and thigh bones.

Most common cancers that may cause bone metastasis are breast cancer, kidney cancer, lung cancer, lymphoma, multiple myeloma, prostate cancer and thyroid cancer, though other cancers may also be the cause. Investigations like bone scan, MRI or CT of bones, and sometimes biopsy from bone may help in confirmation of diagnosis.

Other site of metastasis may be peritoneum, omentum, adrenal gland, or other organs.

The symptoms of stage 4 cancer will depend on the site of metastasis and obviously on the site of origin.

Lung Cancer

It may be the involvement of lung parenchyma or pleural membrane, leading to pleural effusion. Symptoms of stage 4 lung cancer are as follows:

  • Bone pain or fractures – if lung cancer has metastasized to bones.
  • Jaundice, Fatigue, Nausea, or bloating – if lung cancer has metasized to the liver.
  • Vision issues, severe headaches, or seizures – if lung cancer has metasized to the brain.
  • Cough, breathlessness, and chest pain.
  • Loss of appetite.

Lung metastasis are more commonly multiple than single, and bilateral than unilateral. Diagnostic investigations to pickup lung metastasis is X ray chest, and more specifically Ct scan of chest, where they appear as ground glass opacities.

However, other causes must be ruled out like tuberculosis, primary lung malignancy, infections, sarcoidosis, etc. Lung metastasis is mostly seen from breast cancer, GI cancers, osteosarcoma, etc.

Most common sites of spread of lung cancer are adrenal gland, bone, brain, liver and other lung.  Various investigations help in confirming the diagnosis and treatment for lung cancer is done accordingly.

lung cancer metastasisBone Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Pain at the bony site
  • Fracture from minor trauma
  • Spinal cord compression leading to lower limb weakness
  • urinary incontinence
  • bowel incontinence

Any cancer that has metastasized to bones may also cause similar symptoms.

Distant spread may cause:

  • Cough, Breathlessness
  • Pain at distant bony sites

In metastatic disease to bones from other organs, any bone may be involved but most commonly affected are spine, pelvis and thigh bones. Most common cancers that may cause bone metastasis are breast cancer, kidney cancer, lung cancer, lymphoma, multiple myeloma, prostate cancer and thyroid cancer, though other cancers may also be the cause.

Investigations like bone scan, MRI or CT of bones, and sometimes biopsy from bone may help in confirmation of diagnosis.

Bladder Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Pain while urinating or difficulty urinating
  • Blood in urine
  • Increased frequency of urination

Distant spread may cause:

  • Pain in the lower back or other bony sites
  • Abdominal pain, distention
  • Cough, chest pain, breathlessness
  • Jaundice

Most common sites of spread of bladder cancer are bone, liver, peritoneum and lung. Various investigations help in confirming the diagnosis and treatment for bladder cancer is done accordingly.

bladder cancer metastasis infographic

 

Breast Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • A new thickening or lump in the breast or in the underarm area
  • An asymmetrical change in the shape or size of the breasts.
  • Nipple discharge, flattening, inversion, or dimpling.

Distant spread may cause:

  • Chest pain, cough, breathlessness
  • Bone pain
  • Blurry vision, headache or seizures.
  • Jaundice

Most common sites of spread of breast cancer are bone, brain, liver and lung. Various investigations help in confirming the diagnosis and treatment for breast cancer is done accordingly.

Breast Cancer metastasis infographic

Colon Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Constipation or diarrhea.
  • Blood in stools
  • Abdominal pain or bloating.
  • Nausea and vomiting.

Distant spread may cause:

  • Jaundice
  • Abdominal discomfort, distension
  • Breathlessness, cough

Other symptoms may depend on where the colon cancer has spread. Most common sites of spread of colon cancer are liver, peritoneum and lung. Various investigations help in confirming the diagnosis and treatment for colon cancer is done accordingly.

colon Cancer metastasis infographic

As you can see in this figure, the tumor in the right side of colon has spread to the liver.

metastasis to liver

This figure shows the spread of colon cancer to both the lungs, in form of multiple nodular deposits.

spread to both lungs

The tumor may also spread to the peritoneum, in form of peritoneal deposits.

spread to peritoneum

It may rarely spread to one or both the ovaries. Very rarely, the tumor may also spread to the brain or bones.

Kidney Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Blood in the urine
  • Lump in abdomen
  • Abdominal discomfort or pain

Distant spread may cause:

  • Bone pain
  • Headache, vomiting, seizures
  • Jaundice

Most common sites of spread of kidney cancer are adrenal gland, bone, brain, liver and lung. Various investigations help in confirming the diagnosis and treatment for kidney cancer is done accordingly.

kidney Cancer metastasis infographic

This figure shows multiple metastatic deposits in the liver.

metastasized to liver

And here cancer has spread to the lungs in form of multiple nodular deposits.

spread to lungs

It may also spread to the peritoneum in the form of peritoneal deposits, as you can see in this figure.

spread to peritoneum

Metastatic deposits in the adrenal gland without direct extension of a tumor may also be seen.

spread to adrenal glands

Sometimes, it may also spread to the brain or bones.

Ovarian Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Pain, distension, heaviness in abdomen
  • Increased urinary frequency or urgency
  • Abdominal bloating or constipation

Distant spread may cause:

  • Breathlessness, cough, chest pain
  • Jaundice

Most common sites of spread of ovarian cancer are liver and lung. Various investigations help in confirming the diagnosis and treatment for ovarian cancer is done accordingly.

ovarian Cancer metastasis infographic

It may spread to the lungs, which may present as a fluid collection around the lung, called pleural effusion.

spread to lungs

Stage 4 may also present as nodular deposits in the parenchymal of the lung, or in liver or spleen.

liver and splenic deposits

It may also present as the involvement of inguinal lymph nodes.

Pancreatic Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Pain in the upper abdomen or back
  • Newly diagnosed diabetes.
  • Jaundice.
  • Loss of appetite, early satiety, vomiting

Distant spread may cause:

  • Cough, breathlessness, chest pain
  • Jaundice, right upper abdominal discomfort
  • Abdominal distension, bloating

Most common sites of spread of pancreatic cancer are liver, lung and peritoneum. Various investigations help in confirming the diagnosis and treatment for pancreatic cancer is done accordingly.

pancreatic Cancer metastasis infographic

In this figure, it has spread to the peritoneum, in form of multiple peritoneal deposits.

spread to peritoneum

And here, it has spread to the liver in form of multiple nodular deposits.

spread to liver

This figure shows the spread of the tumor to the lungs.

metastasis to lungs

Very rarely, it may also spread to brain or bones.

 

Prostate Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Not able to maintain the flow of the urine.
  • Trouble starting urination
  • Increased frequency of urination
  • Blood in urine or semen.
  • Pain while urinating.

Distant spread may cause:

  • Pain at one or more bony sites
  • Cough, breathlessness
  • Jaundice

Most common sites of spread of prostate cancer are adrenal gland, bone, liver and lung. Various investigations help in confirming the diagnosis and treatment for prostate cancer is done accordingly.

prostate Cancer metastasis infographic

Stomach Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Unexplained weight loss.
  • Nuasea, vomiting.
  • Early satiety
  • Abdominal pain, bloating

Distant spread may cause:

  • Ascites – buildup of fluid in the abdomen
  • Jaundice
  • Cough, breathlessness

Most common sites of spread of stomach cancer are liver, peritoneum and lung.  Various investigations help in confirming the diagnosis and treatment for stomach cancer is done accordingly.

stomach cancer metastasis infographic

Distant metastasis may be seen to the liver.

metastasis to liver

The peritoneum in form of multiple peritoneal deposits.

peritoneal deposits

To the lungs in form of multiple nodular deposits.

spread to lungs

Rarely, it may spread to the left supraclavicular lymph node which presents as nodular deposits in the left side of the neck.

left supraclavicular lymph node involvement

Or a nodular deposit in the periumbilical region called as sister Mary Joseph Nodule.

periumbilical or mary joseph nodule

It may also present as pelvic deposits in the rectovesical pouch or pouch of Douglas.

pelvic deposits in pouch of douglas

Or as nodular deposits in one or both the ovaries, called as Krukenberg’s tumor.

spread to ovaries or krukenberg tumor

Very rarely, it may also spread to brain or bones.

Uterine Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Abnormal uterine bleeding
  • Unusual vaginal discharge.
  • Pain during sexual intercourse.
  • Feeling of pressure in the lower abdomen.

Distant spread may cause:

  • Abdominal distension or bloating
  • Jaundice
  • Cough, breathlessness

Most common sites of spread of uterine cancer are bone, liver, lung, peritoneum and vagina. Various investigations help in confirming the diagnosis and treatment for uterine cancer is done accordingly.

uterinr Cancer metastasis infographic

 

Esophageal Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Dysphagia – difficulty in swallowing.
  • Chest pain, burning sensation.
  • Nausea, vomiting
  • Constant indigestion.

Distant spread may cause:

  • Cough, breathlessness
  • Jaundice

Most common sites of spread of esophageal cancer are bone, liver and lung.  Various investigations help in confirming the diagnosis and treatment for esophageal cancer is done accordingly.

esophageal Cancer metastasis infographic

Like in this figure, cancer has spread to involve both the lungs.

spread to lungs

And here it has spread to the liver in form of multiple nodular deposits.

 spread to liver

Rarely, cancer may spread to bones.

Testicular Cancer

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Painless testicular swelling
  • Change in how testicles feel
  • Ache in the lower abdomen.

Distant spread may cause:

  • Cough, breathlessness
  • Bone pain
  • Jaundice

Other symptoms of testicular cancer may depend on the site of metastasis. Most common sites of spread of testicular cancer are liver, lung and bone.  Various investigations help in confirming the diagnosis and treatment for testicular cancer is done accordingly.

testicular Cancer metastasis infographic

This figure shows metastatic disease due to the involvement of lymph nodes in the mediastinum.

spread to lymph nodes

Similarly, the involvement of inguinal lymph nodes is also metastatic disease because it is a non-regional lymph node for testis.

inguinal lymph node involvement

And here, the involvement of supraclavicular lymph node is non-regional.

left supraclavicular lymph node involvement

Metastatic disease also includes the cases with pulmonary metastasis, that is spread of the tumor to lungs.

metastasis to lungs

In this figure spread to liver makes it metastatic or stage 4 disease

spread to liver

Spread to brain or bones is also metastatic.

Malignant Melanoma

Symptoms may be due to local or distant spread.

Local spread may cause:

  • Itchiness, tenderness or pain on skin
  • Redness, swelling, bleeding in an existing mole
  • Development of pigmented or non-healing sore

Distant spread may cause:

  • Bone pain
  • Cough, breathlessness
  • Jaundice
  • Headache, seizures

Most common sites of spread of melanoma are bone, brain, liver, lung, skin and muscle. Various investigations help in confirming the diagnosis and treatment for melanoma is done accordingly.

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