Lung Cancer: How It Affects Organs & Body Systems

Lung cancer primarily originates in bronchial epithelium but spreads via direct invasion, lymphatics, and hematogenous routes, affecting multiple organ systems.

1. Lungs (Primary Site)

• Central (squamous, small cell) vs. peripheral (adenocarcinoma).
• Airway obstruction → cough, hemoptysis, post-obstructive pneumonia, atelectasis.
• Pleural involvement → malignant pleural effusion (dyspnea, chest pain).

2. Lymphatic Spread

• Hilar (N1) → mediastinal (N2) → contralateral/supraclavicular (N3).
• Nodal bulk compresses airways, SVC, esophagus, recurrent laryngeal nerve (hoarseness).

3. Hematogenous Metastases – Common Sites

4. Paraneoplastic Syndromes

• Endocrine: SIADH (hyponatremia), ectopic ACTH (Cushing’s), PTHrP (hypercalcemia).
• Neurologic: Lambert-Eaton (SCLC), cerebellar degeneration, encephalitis.
• Dermatologic: Dermatomyositis, acanthosis nigricans.
• Hematologic: Trousseau’s (migratory thrombophlebitis), anemia.

5. Systemic Effects

• Cachexia (IL-6, TNF-α, PIF) – weight loss, muscle wasting.
• Anemia of chronic disease.
• Immune suppression.

Pattern of spread guides staging (TNM), treatment selection, and palliative focus.

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Organ	Frequency	Clinical Features
Brain	20–40% (adenocarcinoma, SCLC)	Headache, seizures, focal deficits, cognitive change
Bone	30–40%	Pain, pathologic fracture, spinal cord compression, hypercalcemia
Liver	20–30%	Often asymptomatic; RUQ pain, jaundice, weight loss
Adrenal glands	30–40% (autopsy)	Usually silent; rarely adrenal insufficiency
Contralateral lung	Common	New nodule/mass; distinguish from second primary
Pleura/pericardium	Direct extension	Effusion, tamponade
Kidney, pancreas, thyroid, skin, muscle	Less common	Variable