Bowel cancer that has spread to the lungs
When bowel cancer spreads to the lungs it is called lung metastasis. The lungs are one of the more common sites for bowel cancer to spread. The lungs are breathing organs that are in your chest.
A team of lung experts will help decide the best treatment for you. They will work together to decide the best way to treat and support you.
Treatment for bowel cancer that has spread to the lungs could include:
Chemotherapy
Chemotherapy uses drugs to kill cancer cells. Your healthcare team may offer you chemotherapy to shrink the cancer. You may have one chemotherapy drug or a combination of two or three drugs. If your cancer comes back after treatment, you may be able to have chemotherapy again.
Read more information on chemotherapy drugs and their side effects.
Targeted therapy
A targeted therapy helps your body control the way cancer cells grow. There are different types of targeted treatment that destroy cancer in different ways. You may also hear it being called biological therapy.
Targeted therapy can be used on its own or with chemotherapy.
Targeted therapies don’t work for everyone. Your healthcare team might offer you a test to help find out if there are any targeted therapies that could work for you. This is called a biomarker test. The test could be a blood test or a test on a sample of your tumour from a biopsy.
Read more information about targeted therapy.
Lung surgery
You may be able to have an operation as your first treatment or after another type of treatment. Surgery is not suitable for every bowel cancer patient.
It can take days, weeks or months before you have surgery. Sometimes you might need to have another type of treatment first. If you have another treatment first, it doesn't mean that you will definitely have surgery afterwards. Speak to your healthcare team if you have any questions about your operation.
You may have surgery to remove the cancer from your lungs. This is also known as a lung resection. If your cancer has spread to both lungs, you might need two operations. Surgery is carried out in specialist hospitals, so you may need to travel.
Types of lung surgery
Your surgeon will try to remove all of the tumour(s) and leave as much of the healthy lung as possible.
If your tumour is small or near the edge of the lung, you might have an operation to remove a small section of the lung. This is called a wedge resection.
If the tumour is larger or near the middle of the lung you may have an operation called a segmentectomy. If you need to have a lobe of your lung removed, it is called a lobectomy.
If your cancer has spread to both lungs, it may be possible to treat one lung at a time. This might mean you need a combination of different treatments.
Lung operations are often carried out by keyhole surgery. Keyhole surgery is when the surgeon makes a few small openings to remove the cancer. The surgeon passes special instruments and a thin flexible tube with a light and camera on the end through the small openings to remove the tumour.
Sometimes it is not possible to remove the cancer by keyhole surgery and you may need to have open surgery. This is also called a thoracotomy.
Before surgery
You may need to have treatment before surgery to shrink the tumour. This is called neoadjuvant therapy. It can include chemotherapy and other specialised techniques.
After surgery
If you have open surgery you are likely to stay in hospital for about five days, with at least another few weeks at home to recover. If you have keyhole surgery you may be in hospital for up to four days after the operation.
You are likely to have some pain and discomfort after surgery, but your healthcare team can help you manage this. They can provide pain relief which will help you to get up and move around comfortably and speed up your recovery. Let the team know if you feel your pain is not controlled.
Other lung treatments
Not everyone can have lung surgery. If you can’t have lung surgery, there may be other treatments you can have instead. Your healthcare team will discuss these with you.
Ablative therapies
Ablative therapies use different energy waves to destroy the cancer. Probes (known as electrodes) are placed into the tumour either through your skin or during surgery. A CT scan or an ultrasound scan may be used to guide the electrodes into place. Energy waves are then directed into the tumour and destroy the cancer cells. You will have either a general or local anaesthetic. There are different ablative procedures that are used to destroy the tumours in the lung.
Radiofrequency ablation (RFA)
Radiowaves are used to heat up the cancer cells to high temperatures and destroy them.
For further information about radiofrequency ablation, visit the Cancer Research UK website.
Microwave ablation
Probes that release microwaves are used to heat up and destroy cancer cells. Your healthcare team may recommend microwave ablation if the tumour is large or close to important blood vessels.
Cryoablation
Probes are used to freeze the tumour and destroy the cancer cells. The tumour is thawed for 15 minutes and then refrozen multiple times in cycles.
Stereotactic ablative body radiotherapy (SABR)
Cyberknife is one form of SABR. Small radiation beams are directed from many angles so that they overlap at the tumour. This gives a very high dose of radiotherapy to the cancer. You may need to have small metallic markers put into your lung before the procedure. These markers are guided by a CT scan. This treatment is only available in a few specialist hospitals at the moment.
Macmillan Cancer Support has further information about stereotactic radiotherapy.
More support
Did you know that our online community has a section for people affected by advanced bowel cancer? It’s a welcoming place for everyone affected by advanced bowel cancer to ask questions, read about people’s experiences and support each other.
