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-
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 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.
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.
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.