All you need to know about metastatic cancer

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1. What is metastatic cancer?

Metastasis is the term used to describe the spread of cancer. Unlike normal cells, cancer cells have the ability to grow and move elsewhere in the body, which is called metastatic cancer, or advanced cancer, or stage IV cancer.
Nearly all cancers have the ability to metastasize, but it depends on a number of factors that vary from person to person. Metastatic tumors can occur in three ways:
Cancer cells can move directly into the tissues around the tumor. Cancer cells can travel in the blood to distant sites in the body. Cancer cells can travel through the lymphatic system to nearby or distant lymph nodes. Cancer metastasis occurs when cancer cells break out of the original tumor, enter your bloodstream or lymphatic system, and metastasize to other areas of the body. When cancer cells escape the tumor, they can travel to other parts of the body through the bloodstream or the lymphatic system. Most metastatic cancers are manageable, but not curable. Treatment can relieve your symptoms, slow the growth of the cancer, and improve your quality of life.
All cancers can spread and metastasize. But the term metastatic cancer is usually only used to describe solid tumors, such as breast, prostate or lung cancer, that have spread to another part of the body. Blood cancers, such as leukemia, lymphoma, and multiple myeloma, are not called metastatic cancers because they are thought to have spread when diagnosed.
A person diagnosed with cancer may never develop metastatic cancer. Whether or not cancer spreads depends on many things including:
The type of cancer How quickly the primary cancer grows and how likely it is to spread (grade) The size and location of the cancer primary cancer how long the primary cancer has been in the body If cancer treatments have been used and how well they work Metastatic cancer can develop several years after the cancer primary is first diagnosed and treated.

2. How does metastatic cancer spread?

During metastasis, cancer cells spread from the location in the body where they first formed to other parts of the body.
Cancer cells spread throughout the body in a series of steps:
Grow and invade nearby normal tissue Cancer cells move through the walls of nearby lymph nodes or blood vessels Continues to travel through the lymphatic system and blood flow to other parts of the body Stops in small blood vessels at a site of radiation, penetrates blood vessel walls and moves into surrounding tissue Begins to grow in this tissue until a small tumor forms Grows new blood vessels, creating a blood supply that allows the metastatic tumor to continue to grow. The immune system normally attacks and destroys cancer cells that travel through the lymphatic system or blood. But sometimes cancer cells survive and settle in another area of ​​the body, where they form a new tumor. To survive and grow in a new home, the tumor must form its own blood supply (called angiogenesis). Most of the time, the cancer cells that spread will die at some point during this migration. However, when conditions are favorable for cancer cells at each step, some of them can form new tumors in other parts of the body. Metastatic cancer cells may also remain dormant at a distant site for years before they begin to grow again.

3. What types of cancer are most likely to metastasize?

Breast cancer. Prostate cancer . Lung cancer. Kidney cancer . Thyroid Cancer. Colon cancer. Pancreatic Cancer. Bone cancer. Liver Cancer.

4. Where does the cancer metastasize?

Cancer can spread anywhere in the body, and most cancer cells tend to migrate to the most common organs, for example, metastatic breast and prostate cancer to bone. Colorectal cancer is more likely to metastasize to the liver. Testicular cancer often metastasizes to the lungs, and ovarian cancer often metastasizes to the lining of the abdomen (peritoneum).
Specialists may use the following terms to describe whether the cancer has spread or how far it has spread:
Localized: means the cancer is only in the area where it started and has not spread to other parts of the body. Regional: means the cancer has grown into surrounding tissues or organs or has spread to nearby lymph nodes. Distant: means the cancer has spread to other organs in the body farther than where it formed. Doctors often use the term metastatic cancer to describe cancer that has spread to distant organs or distant lymph nodes (called distant metastases). The most common sites for distant metastasis are the bones, brain, liver, and lungs.
Cancer cells can also spread to the lining around the lungs (pleura), causing malignant pleural effusion, or to the peritoneum, causing malignant ascites.
* Location of metastases with different types of cancer:
Bladder cancer: metastasis to bone - lung - liver Breast cancer : metastasis to bone - brain - liver - lung Colon cancer: metastasis to lung - liver - peritoneal kidney cancer: metastasis to adrenal gland - bone - brain - liver - lung Adrenal cancer: metastasis to lung - bone - brain - liver - lung Malignancy: metastasis to bone - brain - liver - lung - skin - muscle Ovarian cancer: metastasis to lung - liver - peritoneal cancer Pancreatic cancer: metastasis to lung - liver - peritoneum Prostate cancer: metastasis to adrenal gland - bone – liver - lung Rectal cancer: metastasis to lung - liver - peritoneum Stomach cancer: metastasis to lung - liver - peritoneum Thyroid cancer: metastasis to bone - liver - lung Uterine cancer: metastasis to bone - lung - liver - peritoneum - vagina

5. Symptoms of metastatic cancer

Metastatic cancer does not always cause typical symptoms or signs. When symptoms occur and how often you get them will depend on the location and size of the metastases. Some common signs of cancer that has spread include:
Bone metastases:
Cancer that has spread to the bone may or may not cause pain. The first sign of bone metastasis is a fracture after a minor or non-traumatic injury. Severe back pain accompanied by numbness of the legs or difficulty with bowel or bladder control must be evaluated immediately.
Metastasis to the brain:
When a tumor has spread to the brain, it will usually include symptoms such as dizziness, headache, vision problems, speech problems, feeling nauseous, difficulty walking or confusion.
Lung metastases:
Lung cancer symptoms are often vague and have no typical signs. This is because they can resemble symptoms of other health conditions. Warning signs may include cough (sputum production or no result), coughing up blood, chest pain, or shortness of breath.
Metastasis to the liver:
Liver metastases can cause pain, weight loss, nausea, loss of appetite, abdominal fluid (ascites) or jaundice (yellowing of the skin and whites of the eyes).

6. Method of diagnosing metastatic cancer

There is no standard test to diagnose metastatic cancer. Oncologists will order tests based on the type of cancer you have and your symptoms. Possible diagnostic methods are:
Blood tests:
Routine blood tests can tell your doctor if your liver enzymes are elevated. This may indicate liver metastasis. However, in many cases, these blood test results are normal, even if the cancer is advanced.
Tumor markers:
Some cancers have tumor markers that can be useful in monitoring cancer after diagnosis. If the level of the tumor marker goes up, it could mean that your cancer is progressing. Some examples:
Colon cancer: CEA (carcinoembryonic antigen). Ovarian cancer: CA-125. Prostate cancer: PSA (prostate-specific antigen). Testicular cancer: AFP (alpha-feto-protein) and HCG (human chorionic gonadotropin). There are some tumor markers that are less specific and, therefore, are not used as a tool for the diagnosis of metastasis.
Diagnostic imaging for metastatic cancer:
Appropriate imaging tests depending on the symptoms and type of cancer. Imaging tests may include:
Ultrasound: is a way to evaluate the abdomen and identify any tumors. It can detect fluid in the abdomen and can show the difference between a fluid-filled cyst and a solid mass.
CT scan (computed tomography): can detect abnormalities in the head, neck, chest, abdomen and pelvis. It can also identify tumors in the lungs, liver, or lymph nodes.
Bone scan: performed with a radioactive tracer that attaches to the damaged bone and shows up as a "hot spot" on the scan. It is most useful to evaluate the entire body for evidence of cancer-related bone damage. If your provider suspects a fracture, they may take additional X-rays to determine the extent of the damage.
MRI (magnetic resonance imaging): uses radio waves and magnets to take pictures of the inside of your body. MRI can detect spinal cord injury or identify brain metastases.
PET scan (positron emission tomography): works to identify abnormalities in any location on the body. It uses a special dye containing a radioactive tracer to "light up" the areas in question.
The results of these images may not provide a definite answer, but they will serve as a guide for your doctor to locate a suspected tumor. In some cases, the oncologist may also take a biopsy (a small tissue sample) of a suspected metastatic tumor to confirm a diagnosis.

7. Treatment of metastatic cancer

Metastatic cancer is often more difficult to treat than cancer that has not spread. In most cases, the goal of treatment for metastatic cancer is to help a person live as long as possible and maintain their quality of life. Treatments control and slow the growth of metastases, but metastases usually do not go away completely.
Treatments that may be used for metastatic cancer include chemotherapy and other drug therapies, radiation therapy, surgery, and resection therapy. The treatments offered for metastatic cancer are based on several factors, including where the cancer started, your symptoms, the location and amount of metastases, and the treatments given. Use for your primary cancer, your treatment goals, your overall health, and your patient's needs.
Bone metastases:
If the bone tumor is not causing pain, your doctor may monitor your situation or recommend drug treatment. If there is pain or if bone tissue is weak, your doctor may recommend radiation therapy.
Brain metastases:
Depending on the extent of the disease and the number of metastatic tumors, treatment options may include surgery, chemotherapy, radiation therapy, gamma knife surgery, or steroids.
Lung metastases:
The treatment of tumors that have metastasized to the lungs depends on each specific case. In most cases, it will be treated with the same drugs as the primary cancer (where the cancer originated). If fluid builds up around the lungs, a procedure called a thoracentesis can help you breathe easier.
Liver metastases:
There are several ways to treat metastatic tumors of the liver. The appropriate treatment depends on the type of primary cancer and the number of metastases. In many cases, your provider will treat liver metastases the same way they treated the original tumor. If the disease has not spread too far, your provider may recommend surgery or radiofrequency ablation (RFA). Organ transplantation is generally not an option for metastatic disease.
You will also be offered supportive therapies in conjunction with treatments for metastatic cancer. Auxiliary therapies treat the side effects of cancer treatments and symptoms of the disease, but they do not treat the cancer itself. Supportive care helps control or prevent problems caused by metastatic cancer. These therapies may also be called palliative treatments or palliative care.

8. Can metastatic cancer be prevented?

When cancer is found at an earlier stage, systemic treatments performed in addition to surgery (often called adjuvant or neoadjuvant therapy) may be recommended to reduce the likelihood of cancer. metastatic development. These treatments may include chemotherapy, hormone therapy, or immunotherapy. Research is underway in these areas and experts are trying to find ways to slow, stop or stop the spread of cancer cells.

9. Cure and survival rates of metastatic cancer

In most cases, metastatic cancer cannot be cured. However, treatment can slow growth and alleviate many of the associated symptoms. It is possible to live several years with some types of cancer, even if it has metastasized. Some types of metastatic cancer are curable, including melanoma and colon cancer.
The five-year survival rate for metastatic cancer depends on the type of cancer you have. For example, the five-year survival rate for metastatic lung cancer is 7%. This means that 7% of people diagnosed with metastatic lung cancer are still alive after 5 years. Meanwhile, the 5-year survival rate for metastatic breast cancer is 28% for women and 22% for men.

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References: cancer.gov, my.clevelandclinic.org, mdanderson.org