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Metastatic Cancer: What Happens When Cancer Spreads?

Like any other disease, cancer too can spread to other parts of the body.

Metastatic Disease

“When written in Chinese, the word "crisis" is composed of two characters. One represents danger and the other represents opportunity.”

- John F. Kennedy

What is Metastatic Cancer?

Unlike normal cells, cancer cells have the ability to grow outside of the place in the body where they originated. Cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

How Metastases Develop?

The plural of metastasIs is metastases. Metastatic disease may already have happened at the time of diagnosis or may develop later while you are on or off treatment.

Nearly all types of cancer have the ability to metastasize, but whether they do depends on a number of factors.

Metastases occur by certain pathways:

  1. They can grow directly into the tissue or organ surrounding the initial cancer site.

  2. Cancer cells can travel through the bloodstream to distant locations; or travel through the lymphatic system to nearby or distant lymph nodes.

Metastatic Cancer Treatment

Cancer can spread to almost any and every part of the body.

Where in the body cancer can spread?

Several types of cancer tend to follow typical patterns of spread.

For Example:

  • Breast cancer tends to spread to the bones, liver, lungs, and brain.

  • Lung cancer tends to spread to the brain, bones, liver, and adrenal glands.

  • Prostate cancer tends to spread to the bones.

  • Colon and rectal cancers tend to spread to the liver and lungs.

Cancer can also spread, although not typically, to the skin, muscle, or other organs in the body. Cancer cells can also spread to the lining around the lungs called the pleural cavity or to the space around the belly called the peritoneal cavity.

Cancer that has spread to areas near the primary site is called regional metastasis. When cancer spreads to parts of the body that are farther away, it is called distant metastasis.

The spread of cancer also decides the stage of cancer as we explained in previous blogs.

It is important to understand that metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer.

For example:

Breast cancer that spreads to or travels to the lung is metastatic breast cancer, not lung cancer.

When a pathologist looks under the microscope, metastatic cancer cells generally look the same as cells of the original cancer.

Also, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome mutations.

However, sometimes, the metastatic deposit can occur many months or years later and have different molecular signatures than the original cancer as well.

Cancer can behave or rather, misbehave in ways that are under constant study to better understand the process and so we can anticipate and develop optimal treatments.

Cancer can behave or rather, misbehave in ways that are under constant study to better understand the process and so we can anticipate and develop optimal treatments.

Typically, metastatic or advanced cancer requires systemic therapy to reach cancer cells throughout the body.

In some situations, metastatic cancer can be cured, but most commonly, treatment does not completely get rid of cancer.

However, there are treatments to slow its growth and reduce symptoms depending on the type of cancer, whether it is a slow or fast-growing cancer, how it responds to the standard of care or treatment, and also the volume and location of spread.

Anticipating and managing the side effects of cycles of cancer treatment is important.

It is possible to live for many months or years with certain types of cancer, even after the development of metastatic disease with a relatively good quality of life.

It is important to understand the goals of your treatment and have a frank discussion with your cancer care team.

These goals may change during your care, depending on whether cancer responds to the treatment and also whether you can be part of newer clinical trials for your type of cancer.

Metastatic Cancer Symptoms

“Research is to see what everybody has seen and think what nobody has thought.”

Albert Szent-Györgyi , Nobel Prize Winner

Reason to hope: A new advanced computing technique using medical scans to enable doctors to take fewer, more accurate tumor biopsies, has been developed by cancer researchers at the University of Cambridge. This is an important step towards precision tissue sampling for cancer patients to help select the best treatment. European Radiology, 2020; DOI: 10.1007/s00330-020-07560-8

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Reason to Hope

There is new research from Brigham and Women’s Hospital that indicates a Western-style diet that is rich in red and processed meat, sugar and refined grains/carbohydrates is tied to higher risk of colorectal cancer through the intestinal microbiota.  Gastroenterology, 2022;DOI:10.1053/j.gastro.2022.06.054 

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