*The process of metastasis formation is a major challenge to cancer researchers.
*90% of cancer-related deaths are due to metastasis.
*Recent advances are an unprecedented opportunity to start designing specific treatments for metastasis.
Many tumors can be removed with surgery, chemotherapy, radiotherapy and other treatments. However, once the cancer has spread to other parts of the body (metastasis), it is much more difficult to stop. Researchers at the most prestigious centres in the world are working on new ways to treat metastatic cancer. Below are six frequently asked questions about metastasis:
Metastatic cancer occurs when tumour cells from the original tumour spread through the bloodstream, or lymphatic vessels, to another part of the body where they form new tumours.
The neighbouring lymph nodes are the most common place for metastatic cancer. Tumour cells also tend to spread to the liver, brain, lungs and bones. Certain types of cancer are more likely to spread to certain organs. Melanoma, the most dangerous type of skin cancer, frequently spreads to the brain and lungs. Prostate cancer often spreads to bones.
After a cancer has invaded another organ, it is still identified by the place where it developed. For example, cancer of the colon which has spread to the liver is not the same as primary liver cancer. Instead it is called liver metastasis or secondary liver cancer. Breast cancer which spreads to the lungs is still treated as breast cancer, not as lung cancer. If the original tumour responds to hormone therapy, which is often used in the treatment of breast cancer, it is likely that metastatic lung tumours will respond to it too.
The symptoms of metastatic cancer vary greatly according to the type of cancer and the area to which it has spread. When cancer has spread to the brain, the common symptoms include headaches, seizures and visual problems. When cancer has spread to the liver, people can develop jaundice (when the skin or eyes become yellow), leg swelling, fatigue, weight loss and loss of appetite.
In some cases, cancer may spread after a person has already had treatment for the original tumour. Metastatic tumours can appear months, or even years, after initial treatment. In other cases, people may not be aware of having cancer at all until they notice symptoms due to the location of a metastasis.
There are many cancer treatments, the treatment selected depends on the primary source of the cancer and to where it has spread. Chemotherapy is used frequently, together with radiotherapy, to reduce tumours.
The first step in determining if targeted therapy can be effective is to find out if there are any genetic mutations related to a person’s cancer. There are already methods to analyse genetic mutations in tumours. At HC Marbella these are available for all patients who have metastatic cancer, and are used to find specific mutations in tumours which can be treated with targeted drugs.
There are also immunotherapy options for some tumours, these are drugs designed to increase the body’s immune response, helping it to destroy tumour cells.
As researchers continue to make advances in new treatments, there are more curative options for certain types of metastatic cancer, such as cancer of the colon and melanoma. But often, metastatic cancer treatment is palliative, that is to say, treatment reduces symptoms and improves a person’s quality of life, but it cannot completely eliminate the cancer. For many people palliative treatment may keep the disease under control for many years. Some drugs are able to contain the tumour for a long time if patients continue taking them, although resistance may eventually develop. It is therefore possible for cancer to become a chronic, manageable condition allowing people to live with it for a long time.
At this moment in time there are no effective methods which prevent the spread of cancer. The best way of avoiding spread is to eliminate primary tumours when they are very small, before they have the chance to migrate to other areas of the body. This is part of the reason why cancer screening is so important. However, even when cancer is found and removed early, it is possible that tumour cells are already hiding in other parts of the body, or circulating in the blood and lymphatic vessels.
Dr. Hernan Cortes-Funes, Director of the Oncology Unit at HC Marbella concludes:“Metastasis can be prevented, treated or become a chronic condition, in that order of preference, but nothing is straight forward. In the next few years we will see significant advances in understanding why metastatic cells demonstrate a particular metabolism and why they are genetically altered to be stronger”.
Sources: NIH-National Cancer Institute / Memorial Sloan Kettering Cancer Center.
August 2, 2018
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