Metastatic Cancer

What is Metastatic Cancer

Metastatic cancer is cancer that has spread from the place where it started (primary site) to another part of the body. The process of cancer spreading from the primary site is called metastasis.

When cancer cells metastasize, they do not change the way they look or the way they affect the body. An example is when primary lung cancer spreads to the brain. This is called metastatic lung cancer, not brain cancer.

All types of cancer can spread. Some cancers are more likely to metastasize than others. The most common places that cancers metastasize to are:

  • Bones.
  • Liver.
  • Lungs.

What are the causes?

Metastasis occurs when cancer cells spread from the primary site to another part of the body. Cancer cells can spread:

  • Directly from one part of the body to a nearby area (local invasion).
  • Into a lymph vessel. Cancer cells can be carried through the lymph system to lymph nodes and other parts of the body. The lymph system is a network of vessels and nodes that help protect against infections.
  • Into the blood vessels. Cancer cells can be carried to other parts of the body through the bloodstream.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • The type of cancer that you have.
  • The stage and grade of your primary cancer at the time of diagnosis.
  • The grade and stage of the tumor. Grading and staging predict how quickly cancer cells will grow and their chances of metastasis.
  • A large primary tumor.
  • A higher grade of tumor.
  • Deeper growth of tumor.
  • A tumor that has entered the lymph system.

What are the signs or symptoms?

Symptoms of this condition include:

  • Weakness.
  • Lack of energy.
  • Pain.
  • Weight loss.
  • Trouble breathing.
  • Fluid buildup in your lungs or abdomen.
  • Tumor growths that can be felt or seen.
  • An enlarged liver.

Some people with this condition may have no symptoms.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your symptoms.
  • Physical exam. This may include:
    • Blood tests to check for certain substances that are secreted by tumors (tumor markers).
      • Tumor markers that increase after treatment can indicate metastasis.
      • Tumor markers may be used to help diagnose metastasis in some cancers, such as colon and prostate cancer.
        • Not all cancers have tumor markers.
    • Imaging studies, such as:
      • X-rays.
      • Ultrasound.
      • MRI.
      • Other imaging tests, such as CT scans, bone scans, and PET scans.
    • Testing tissue that is removed from the new cancer site (biopsy). If the cells are similar to cancer cells from the primary site, this can confirm metastatic cancer.
    • Testing fluid samples from the lungs, spine, or abdomen for metastatic cancer cells.

How is this treated?

There are many options for treating metastatic cancer. Your treatment will depend on:

  • The type of cancer you have.
  • How far your cancer has advanced.
  • Your general health.

Treatment may not be able to cure metastatic cancer, but it can often relieve the symptoms. In many cases, you may have a combination of treatments. Options may include:

  • Surgery.
  • Medicines that kill cancer cells (chemotherapy).
  • High-energy rays that kill cancer cells (radiation therapy).
  • Targeted therapy. This targets specific parts of cancer cells and the area around them to block the growth and the spread of the cancer. Targeted therapy can help to limit the damage to healthy cells.
  • Hormone therapy.
  • Treatments that help your body fight cancer (biologic therapy).
  • Medicines that help your body’s disease-fighting system (immune system) fight cancer cells (immunotherapy).
  • Freezing cancer cells using gas or liquid that is delivered through a needle (cryoablation).
  • Destroying cancer cells using high-energy radio waves that are delivered through a needle-like probe (radiofrequency ablation).
  • A procedure to block the artery that supplies blood to the tumor, which kills the cancer cells (embolization).
  • Other medicines to manage symptoms related to cancer or cancer treatments.

Follow these instructions at home:

Eating and drinking

  • Some of your treatments might affect your appetite and your ability to chew and swallow. If you are having problems eating, or if you do not have an appetite, meet with a diet and nutrition specialist (dietitian).
  • If you have side effects that affect eating, it may help to:
    • Eat smaller meals and snacks often.
    • Drink high-nutrition and high-calorie shakes or supplements.
    • Eat bland and soft foods that are easy to eat.
    • Avoid foods that are hot, spicy, or hard to swallow.

Lifestyle

  • Do not drink alcohol.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider. This includes vitamins, supplements, and herbal products.
  • Work with your health care provider to manage any side effects of treatment.
  • Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

Contact a health care provider if you:

  • Notice that you bruise or bleed easily.
  • Are losing weight without trying.
  • Have new or increased fatigue or weakness.

Get help right away if you have:

  • A seizure.
  • A sudden increase in pain.
  • A fever.
  • Shortness of breath.
  • Chest pain.

Summary

  • Metastatic cancer is cancer that has spread from the place where it started (primary site) to another part of the body.
  • Cancer cells can spread directly from one part of the body to a nearby area, or they may spread through the lymph system or the bloodstream.
  • Your risk for metastatic cancer depends on the type of cancer you have and the stage and grade of your primary cancer.
  • Treatment may not be able to cure metastatic cancer, but it can often relieve the symptoms.
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