Lung cancer can affect people’s skin in different ways. Some people may experience unusual skin reactions due to lung cancer itself or as a side effect of lung cancer treatments. In rare instances, skin lesions or marks might indicate that lung cancer has metastasized (spread) to the skin.

Here’s what you should know about this uncommon (but possible) progression of lung cancer.

What Is Lung Cancer Skin Metastasis?

“Lung cancer skin metastasis” may sound complicated, but it simply means that the cancer from your lungs has spread to your skin. This is different from skin cancer, because it’s directly related to lung cancer. Skin cancer is a separate condition, where the primary tumor is on the skin.

Any form of lung cancer can spread to the skin or other parts of the body. Adenocarcinoma is the most common type of lung cancer that spreads to the skin.

Metastasis is a sign that cancer is becoming a bigger threat to your body. Although metastasis of any type is a cause for concern, it’s important not to panic. Skin changes can happen for various reasons, especially when you’re having cancer treatments. There are treatment options available for lung cancer skin metastasis that you can discuss with your health care team.

How Often Does Lung Cancer Spread to the Skin?

Lung cancer doesn’t usually spread to the skin. Studies estimate that skin metastasis only occurs in about 1 percent to 12 percent of cases. When lung cancer does metastasize, it more commonly spreads to the adrenal glands, hilar nodes, bones, brain, or liver. However, for 25 percent of people with metastatic lung cancer, the skin is the first site of metastasis.

According to the Journal of Wound Management and Research, males with lung cancer are more likely to have skin metastasis than those with different types of cancer. However, females with lung cancer aren’t as likely to have skin metastasis as those with other types of cancer, such as colon or breast cancer.

Where and When Does Skin Metastasis Happen?

If lung cancer spreads to the skin, the most common sites include the head, neck, chest, and abdomen. The nodules are usually round or oval. They’re either firm and raised or they look like skin ulcers. Unlike ulcers, they usually don’t hurt, and they won’t heal on their own.

Skin metastasis can appear anywhere on the body and may look different from person to person. Because it can be difficult to identify, experts recommend considering the possibility of lung cancer metastasis for skin lesions in individuals with a smoking history, even if they haven’t been diagnosed with lung cancer.

Sometimes, metastatic skin lesions appear before a lung cancer diagnosis is made. Other times, both diagnoses occur simultaneously. Some case reports suggest an average span of 14 to 16 months between the initial lung cancer diagnosis and the discovery of skin metastasis. However, there have been cases where the time between these two issues has been as long as 10 years.

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What Are the Diagnosis and Treatment Options?

Anytime lung cancer spreads to a different part of the body, it means the cancer is progressing. Metastasis to the skin generally has a poor prognosis and may require more aggressive treatment or a different approach to your cancer care. Some studies report that individuals with lung cancer may have a mean survival of five to six months after it spreads to the skin.

However, every person is unique, and even experts can’t always predict exactly how cancer will respond to treatment or impact an individual’s life expectancy. The most important thing is to discuss any changes with your doctor right away so you can take action and get checked out.

To see if the area of the skin has cancer cells, your doctor may refer you to a dermatologist to do a skin biopsy. This procedure involves removing part of the lesion for lab testing. If the lesion is metastatic, a larger excision (surgical removal) of the tumor cells will be necessary. If the cancer has only spread to the skin, possible treatment options include surgery to remove the skin lesion, chemotherapy, interferon alpha injections, radiation therapy, and radiofrequency ablation.

What Does Lung Cancer Metastasis Mean for You?

Hearing that your lung cancer has spread is difficult. Despite your best efforts to maintain a healthy lifestyle, cancer can be unpredictable and uncontrollable. People react to such news in various ways, including depression, anger, anxiety, or guilt. It’s normal to feel surprised and have difficulty processing this information.

If you feel overwhelmed, communicate this to your health care provider. Let them know if you need more time before discussing details. This is a good time to consider what’s most important to you and to get organized. Write down questions you want to ask, and bring a support person to your appointments to help absorb the information. Reflect on how you want to spend your time and what is and isn’t worth worrying about.

Connecting with people who listen and empathize with your situation can help you feel less alone. Let your doctor know if you need mental and emotional support to deal with challenging news. They may refer you to a counselor or support group to help you cope.

When Should You Contact Your Doctor?

Sometimes, metastatic skin lesions can be mistaken for wounds. If this happens, your doctor might suggest delaying cancer treatments, such as chemotherapy, to allow the wound to heal. However, since the lesion is actually cancer and not a wound, it would benefit from cancer treatments like chemotherapy, immunotherapy, or targeted therapy, depending on the type of lung cancer. Delaying lung cancer treatment could do more harm than good.

That’s why it’s crucial to get the right diagnosis, especially if you have wounds that don’t seem to heal on their own. Trust your intuition, and seek a second opinion if your concerns aren’t being addressed.

Getting help is important even if your skin symptoms aren’t metastatic lung cancer. People with lung cancer may develop skin cancer that requires treatment of its own. Skin problems can also happen because of other issues, like eczema, allergies, infections, or medication side effects. Understanding your new symptoms will provide peace of mind and the best chance for effective treatment and improved quality of life.

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. On MyLungCancerTeam, more than 13,000 members come together to ask questions, give advice, and share their experiences with others who understand life with lung cancer.

Was your initial diagnosis of lung cancer prompted by metastatic tumors? Did your lung cancer spread to the skin after your initial diagnosis? Share your experiences in the comments below, or start a conversation by posting on MyLungCancerTeam.