You've probably heard the word "metastasis," especially when talking about cancer. It's a scary word. But if you understand it correctly , you can reduce that fear a bit. So today, let's talk about what metastasis is, how it happens, and what are the important things to know about it.
What is Metastasis? Let's understand it simply.
Simply put, metastasis is the spread of cancer from where it first started to other parts of the body, that is, to other organs. Think of it like a small plant that starts in one place and over time, it spreads and grows new plants. Almost all cancers have some ability to spread in this way. However, whether or not it spreads depends on several factors. For example, the type of cancer, its size, and where the cancer first started – we call it the 'primary tumor' – all of these factors play a role.
Now, look, there are three main ways that these cancer cells can travel to other parts of the body:
- The first method: Cancer cells can grow directly into the tissue surrounding the primary tumor, as if pulling out roots.
- The second method: These cancer cells travel through the bloodstream, that is, along the circulatory system , to other organs in distant parts of the body, such as the liver, lungs, brain, and bones.
- The third way: Through the lymphatic system . This is another important system in our body. Through this, cancer cells can spread to nearby and sometimes distant lymph nodes.
What are other names for metastasis?
Doctors use several other names for metastasis. You may have also heard these words:
- Metastatic cancer
- Stage IV (4) cancer
- Secondary cancer
- Sometimes it is also called cancer with "mets" for short.
Whatever the name, it means the same thing.
What types of cancer spread (metastasize) like this?
In fact, any type of cancer has the potential to spread, or metastasize, in this way. However, some types of cancer seem to spread more than others. Here are some of the types of cancer that most commonly metastasize:
- Breast cancer
- Colorectal cancer
- Esophageal cancer
- Lung cancer
- Ovarian cancer
- Pancreatic cancer
- Prostate cancer
- Skin cancers, especially melanoma
- Stomach cancer
- Uterine cancer
Don't be alarmed by this list. This doesn't mean that all of these cancers will spread if they develop. But it's important to be aware that these types have the potential to do so.
Where does cancer first spread?
When a cancer metastasizes, the organ it goes to first is often determined by the primary tumor , the place where the cancer first started. This means that each type of cancer has a preference for spreading to. Here are some of the most common places where cancer spreads:
- Adrenal glands (these are small glands located on top of our kidneys)
- Bones
- Brain
- Liver
- Lungs
- Lymph nodes
- Peritoneum (this is a thin membrane that covers the abdominal organs)
For example, breast cancer is more likely to spread to the bones, lungs, liver, and brain. Similarly, colon cancer can spread to the liver and lungs.
What are the symptoms of metastatic cancer?
Metastasis does not always cause major symptoms. Sometimes cancer cells can spread for months or even years. Therefore, some people may not know they have stage IV cancer .
However, there are several common symptoms that are usually seen with metastasis:
- Feeling very tired, extreme fatigue
- Night sweats
- Unexplained weight loss
Additionally, symptoms can vary depending on where the cancer was originally located and where it has spread to. Consider this:
- If the cancer has spread to the liver (liver metastases) , symptoms may include: bloating, abdominal distension, loss of appetite, feeling full even after eating a small amount, and possibly jaundice (yellowing of the eyes and skin).
- If the cancer has spread to the bones (bone metastases) : Bone pain and easy fractures may occur.
- If the cancer has spread to the brain (brain metastases) , symptoms such as dizziness, severe headaches, and seizures may occur.
- If the cancer has spread to the lungs (lung metastases) , symptoms such as shortness of breath and a persistent cough may occur.
Important: Having these symptoms doesn't necessarily mean you have metastatic cancer. They can also be caused by other health problems. However, if these symptoms persist, it's best to see a doctor for advice.
What are the causes of metastasis?
Metastasis is a process in which cancer cells break away from the primary tumor and travel to other parts of the body. As we discussed earlier, these cells travel through the bloodstream or lymphatic system.
There are several factors that can influence the spread of cancer cells in this way, that is, stimulate this process. Scientists are still researching this. As far as we know, these factors can be:
- A weakened immune system .
- Lack of oxygen to tissues (Hypoxia) .
- Increased lactic acid in the blood (Lactic acidosis) .
- Some changes in a cell death process called autophagy . (These are somewhat complex biological processes.)
These factors help cancer cells escape from their original tumor, migrate to new locations, and establish new colonies there.
How is metastatic cancer diagnosed?
For some people, when they are first diagnosed with cancer, it may be in the metastatic stage, meaning it has spread to other parts of the body. In that case, the doctor will detect these metastases during the first tests they perform.
For some people, metastasis may occur after the initial cancer has been treated. That's why doctors often recommend follow-up checkups after cancer treatment. At that time, they check to see if the cancer has recurred or spread.
What tests are done to detect metastasis?
If your doctor suspects metastatic cancer, they may do one or more of these tests to confirm it:
- Biopsy: This involves taking a small piece of tissue from a suspicious area and examining it under a microscope. This can help determine exactly if there are cancer cells and what type they are.
- Blood tests: In some types of cancer, certain things in the blood (such as tumor markers ) increase. They can also give an idea of how organs (such as the liver and kidneys) are functioning.
- Bone scans: This helps to see if the cancer has spread to the bones.
- CT scan (computed tomography scans): Can take detailed pictures of the inside of the body. Helps find things like tumors and growths.
- MRI (magnetic resonance imaging) scans: This is similar to a CT scan, but is better suited for looking at soft tissues, especially the brain and spinal cord.
- PET scan (positron emission tomography scans): This can see how active cancer cells are and where they are in the body.
- Ultrasound: Uses sound waves to take pictures of the inside of the body.
- X-rays: Used to look at things like lungs and bones.
Not all of these tests are done for everyone. Your doctor will decide which tests to do based on your symptoms and the type of cancer.
How is metastatic cancer treated?
The important thing here is that no matter where the cancer has spread, the treatment is based on where the cancer first started . For example, if someone has breast cancer and it later spreads to the liver, doctors treat it the same way they treat breast cancer. Because the liver contains the same breast cancer cells, they haven't changed, only the location has changed.
There are several main treatments for metastatic cancer:
- Chemotherapy: This involves giving the body drugs that kill cancer cells or stop them from growing. These can be given as pills or as a liquid given into a vein.
- Hormone therapy: Some types of cancer (e.g. breast, prostate) are hormone-dependent. This treatment works by reducing or stopping the action of those hormones.
- Immunotherapy: This involves stimulating our body's own immune system and helping it fight cancer cells.
- Radiation therapy: Uses high-energy rays to destroy cancer cells. This can be targeted to a specific area of the body.
- Targeted therapy: These drugs are designed to attack only specific genetic changes in cancer cells, so they cause less damage to healthy cells.
Sometimes, local targeted therapy can be used to control symptoms caused by metastasis, such as reducing pain and preventing bone fractures. For example, if cancer has spread to a bone and is causing pain, radiation therapy or surgery may be used to treat that area.
Can metastasis be prevented?
Cancer cannot always be completely prevented from spreading. However, if cancer is detected early , that is, before it has spread, surgical removal of the tumor and subsequent adjuvant therapy (such as chemotherapy, targeted therapy, or immunotherapy) can significantly reduce the risk of later metastasis.
Experts are still researching ways to stop, slow, or completely prevent the spread of cancer cells. But sometimes, no matter how well we do things, something called metastasis can happen.
Remember this: If you have metastatic cancer, it's not your fault . It's not because you did anything wrong or didn't do anything. Research shows that there are no specific foods that make cancer more likely to develop, nor are there specific foods that prevent metastasis.
If I have metastatic cancer, what should I expect?
Your medical team will work closely with you during and after cancer treatment. You will have regular appointments and will have to make important decisions about your health. At this time, it is important to have support from your family, friends, and medical team .
Life expectancy with metastatic cancer
In most cases, metastatic cancer is not curable . However, treatment can control the growth of the cancer and reduce symptoms. With some types of cancer, even with metastases, you can live for many years . Also, some types of metastatic cancer, such as melanoma and colon cancer, are curable.
Survival rates of metastatic cancer
The five-year survival rate varies depending on the type of metastasis you have. For example, 9% of people with metastatic lung cancer are still alive after five years. This means that 9 out of 100 people diagnosed with metastatic lung cancer are still alive after five years. Similarly, 30% of women and 19% of men with metastatic breast cancer are still alive after five years.
It's important to understand: These survival rates are just general estimates . They don't tell you exactly how you will respond to treatment or how long you will live. Ask your doctor about the survival rates that apply to your condition.
How do I take care of myself?
Being diagnosed with metastatic cancer comes with its own challenges. These challenges can vary from person to person, but you may experience things like:
- Feelings like sadness, anger, and disappointment.
- I'm afraid that the treatment will be successful or that the cancer will get worse quickly.
- It's tiring to constantly see doctors and make important decisions.
- Needing help with daily tasks.
- Disappointment over the cost of treatment.
Talking to a counselor or social worker can be a great help in dealing with these complex feelings. Also, managing stress is very important. Practice things like meditation, mindfulness, or find other ways to reduce stress.
When should I see my doctor?
If you develop any new symptoms, you should talk to your doctor right away . Your cancer care team can adjust your treatment plan to suit your needs.
What questions should I ask my doctor?
Being aware of your condition will help you make informed decisions. Here are some questions you can ask your doctor:
- Are there things I can do to improve my situation?
- What treatment options do I have?
- Are there any clinical trials I can participate in?
- Even if I stop cancer treatment, will I continue to receive palliative care ? (Palliative care is care that controls symptoms and improves quality of life)
- How often do I need to come for follow-up checkups?
- Should I consider hospice care ?
- If I am unable to make decisions, should I choose someone to make medical decisions for me now?
- What legal documents do I need to prepare?
- Can you tell me about resources that will help me cope with this diagnosis?
Finally, what to remember (Take-Home Message)
Finding out that cancer has spread from its original site to another part of the body, or metastasized , can be one of the most terrifying experiences a person can face in their life. If you have recently been diagnosed with this, it is normal to have a range of complex emotions running through your mind.
Although most metastatic cancers cannot be completely cured, there are treatments that can help relieve your symptoms and extend your life . So, don't give up hope.
Ask your doctor for more information and find out where you can get help. If possible, join a cancer support group in your area. Talking to others who are going through the same things as you can can help you feel better about yourself during this journey. Always remember that you are not alone.
` Cancer, metastasis, spread of cancer, cancer symptoms, cancer treatment, stage IV cancer, cancer cure
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