Know About Metastatic Cancer

By Dr. Puneet Gupta in Cancer Medical Oncology

Jul 17, 2018

Metastatic Cancer discussions and mentions are doing rounds in social media now-a-days after reported diagnosis of the same in one of the former leading bollwood actress, Sonali Bendre. Dr. R K Choudhary, Consultant – Medical Oncology and Dr. Puneet Gupta, Director – Oncology and Senior Consultant – Medical Oncology, in our special series- Metro Doctor Speak, answers some important questions on Metastatic Cancer.

What is Metastatic Cancer?

Generally cancer has the tendency to get spread from its initial position to other parts of the body. The original cancer is known as primary tumor, whereas the cancer in other parts of the body is known as metastases. The cancer cells presents in metastatic cancer are same as of primary cancer. For example: when the colon cancer spread to other part of the body such as liver, the cancer cells present in the liver are colon cancer cells. It is known as metastatic colon cancer and not as liver cancer.

Metastatic Cancer is also known as:

• Metastatic tumor, tumors or disease
• Metastatic (one cancerous tumor)
• Metastases (more than one cancerous tumor)
• Advanced cancer

When Metastatic cancer develops?

Mostly all the cancers have the tendency to spread to other parts of the body. Generally the term metastatic cancer is only used to define the solid tumors which have spread to other parts of the body. There are certain cancers such as leukemia, lymphoma and multiple myeloma are considered as widespread when they are diagnosed and hence they are not referred as metastatic cancer.

The spread of the cancer depends on the following factors:

• The type of cancer
• The grade of the primary cancer
• The location and size of the primary cancer
• The time duration of the primary cancer in the body
• If cancer treatments were used and how well they have worked

In most of the scenarios metastatic cancer might develops after many years the primary cancer is first diagnosed. There are certain cases where the cancer has already metastasized when it’s diagnosed.

How cancer spread?

When cancer cells grow and start to divide, they have the tendency to move from their initial position to the other areas of the body. There are majorly 3 ways in which the cancer is spread to other parts of the body:

• Direct Extension, or invasion- direct extension or invasion means that the primary tumor grows into tissues or structures around it. e.g., In case of prostate cancer, this cancer grows into the bladder.
• Lymphatic system spread: under this system the cancer cells will break away from the primary tumor and thus will travel to another part of the body through the lymphatic system. The lymphatic system consists of group of tissues and organs that make and store cells which are helpful in fighting infection and diseases. Eg. Breast cancer going to axillary lymph nodes.
• Bloodstream, or hematogenous: under hematogenous spread the cancer cells break away from the primary tumor and thus enters the bloodstream travelling to a new place in the body.

In general the immune system attacks and destroys the cancer cells which travels through the bloodstream but in various scenarios when the cancer cells manages to survive and settle down in another area of the body, where they develops a new tumor. To survive while growing at the new location in the body, the tumor must form its own blood supply known as angiogenesis.

Where cancer spreads?

Cancer holds the tendency of spreading to other parts of the body, such as breast cancer and prostate cancer spread to the bones most often; whereas colorectal cancer majorly spreads to the liver. Testicular cancer usually spread to the lungs while the ovarian cancer generally spreads to the peritoneum.

Mentioned below are certain terms which doctors may use to describe if the cancer has spread or not and if yes then how far it has spread:

• Localized: the term localized means that the cancer has not spread to any other part of the body, it is still in the area from where it has started.
• Regional: under this condition the cancer cells have spread to the nearby lymph nodes and into the surrounding tissues or organs.
• Distant: this term means that cancer is in a part of the body farther from where it was started.

How metastatic cancer is treated?

Usually metastatic cancer is more difficult to treat than the cancer which hasn’t spread. In most of the cases, the main aim of treatment for metastatic cancer is to continue the survival while maintaining the quality of the life. Treatment slows down the growth of metastases, but the metastases usually don’t go away completely.
The treatment provided for metastatic cancer are based on various factors such as the location of the cancer, symptoms, amount of metastases, the treatment which is used for the original cancer, the treatment goal, age, the overall health, other medical conditions and personal preferences.