Cancer Overview

Cancer Overview

 

Cancer Overview.
Source: Collmed

  1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.
  2. Cancer cells occur between 6 to more than 10 times in a person’s lifetime.
  3. When the person’s immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors. To strengthen the Immune system it is necessary to detoxify the body from fungi caused from too many antibiotics in our medical therapies and in our foods), parasites, and heavy metals. Something as simple as cilanto and selenium, found in garlic, can help to eliminate heavy metals. Herbs such as gentian violet, dandelion root and pokeweed or wild oregano oil kill parasites and fungi.
  4. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle factors.
  5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.
  6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.
  7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.
  8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.
  9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.
  10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.
  11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.

CANCER CELLS FEED ON:

  1. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells. Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but only in very small amounts. Table salt has a chemical added to make it white in colour. Better alternative is Bragg’s aminos or sea salt, or Himalayan salt.
  2. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened rice milk cancer cells are being starved.
  3. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.
  4. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells. To obtain live enzymes for building healthy cells try and drink fresh vegetable juice, including carrot juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of104 degrees F (40 degrees C).
  5. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties. Water: best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.
  6. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines become putrefied and leads to more toxic buildup.
  7. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body’s killer cells to destroy the cancer cells.
  8. Some supplements build up the immune system (IP6, Flor-essence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the body’s own killer cells to destroy cancer cells. Other supplements like vitamin E succinate are known to cause apoptosis, or programmed cell death, the body’s normal method of disposing of damaged, unwanted, or unneeded cells.
  9. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, unforgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.
  10. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.

“Cancer is a word, not a sentence.”
John Diamond


Immune cells working together to defeat cancer cells.

 

Defining Cancer

Source: The website of the National Cancer Institute (http://www.cancer.gov)

cell doubling timeCancer is a term used for diseases in which abnormal cells divide without control and are able to invade other tissues.
Cancer cells can spread to other parts of the body through the blood and lymph systems.

Cancer is not just one disease but many diseases. There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start – for example, cancer that begins in the colon is called colon cancer; cancer that begins in melanocytes of the skin is called melanoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:

Carcinoma – cancer that begins in the skin or in tissues that line or cover internal organs. There are a number of subtypes of carcinoma, including adenocarcinoma, basal cell
carcinoma, squamous cell carcinoma, and transitional cell carcinoma.

Sarcoma – cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Leukaemia – cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.

Lymphoma and myeloma – cancers that begin in the cells of the immune system.

Central nervous system cancers – cancers that begin in the tissues of the brain and spinal cord.

Origins of Cancer

All cancers begin in cells, the body’s basic unit of life. To understand cancer,
it’s helpful to know what happens when normal cells become cancer cells.

The body is made up of many types of cells. These cells grow and divide in a controlled way to produce more cells as they are needed to keep the body healthy. When cells become old or damaged, they die and are replaced with new cells.

However, sometimes this orderly process goes wrong. The genetic material (DNA) of a cell can become damaged or changed, producing mutations that affect normal cell growth and division. When this happens, cells do not die when they should and new cells form when the body does not need them. The extra cells may form a mass of tissue called a tumor.

Not all tumors are cancerous; tumors can be benign or malignant.

  • Benign tumors aren’t cancerous. They can often be removed, and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body.
  • Malignant tumors are cancerous. Cells in these tumors can invade nearby tissues and spread to other parts of the body. The spread of cancer from one part of the body to another is called metastasis.

Some cancers do not form tumors. For example, leukaemia is a cancer of the bone marrow and blood.

Risk Factors

Doctors often cannot explain why one person develops cancer and another does not. But
research shows that certain risk factors increase the chance that a person will develop
cancer. These are the most common risk factors for cancer:
• Growing older
• Tobacco
• Sunlight
• Ionizing radiation
• Certain chemicals and other substances
• Some viruses and bacteria
• Certain hormones
• Family history of cancer
• Alcohol
• Poor diet, lack of physical activity, or being overweight
Many of these risk factors can be avoided. Others, such as family history, cannot be avoided.
People can help protect themselves by staying away from known risk factors whenever possible.

Symptoms

Cancer can cause many different symptoms. These are some of them:
• A thickening or lump in the breast or any other part of the body
• A new mole or a change in an existing mole
• A sore that does not heal
• Hoarseness or a cough that does not go away
• Changes in bowel or bladder habits
• Discomfort after eating
• A hard time swallowing
• Weight gain or loss with no known reason
• Unusual bleeding or discharge
• Feeling weak or very tired

Most often, these symptoms are not due to cancer. They may also be caused by benign tumors or other problems. Only a doctor can tell for sure. Anyone with these symptoms or other changes in health should see a doctor to diagnose and treat problems as early as possible. Usually, early cancer does not cause pain. If you have symptoms, do not wait to feel pain before seeing a doctor.

Diagnosis

If you have a symptom or your screening test result suggests cancer, the doctor must find out whether it is due to cancer or to some other cause. The doctor may ask about your personal and family medical history and do a physical exam. The doctor also may order lab tests, x-rays, or other tests or procedures.

Lab Tests
Tests of the blood, urine, or other fluids can help doctors make a diagnosis. These tests can show how well an organ (such as the kidney)
is doing its job. Also, high amounts of some substances may be a sign of cancer. These substances are often called tumor markers. However, abnormal lab results are not a sure sign of cancer. Doctors cannot rely on lab tests alone to diagnose cancer.

Imaging Procedures
Imaging procedures create pictures of areas inside your body that help the doctor see whether a tumor is present. These pictures can be made in several ways:

  • X-rays: X-rays are the most common way to view organs and bones inside the body.
  • CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your organs. You may receive a contrast material (such as dye) to make these pictures easier to read.
  • Radionuclide scan: You receive an injection of a small amount of radioactive material. It flows through your bloodstream and collects in certain bones or organs. A machine called a scanner detects and measures the radioactivity. The scanner creates pictures of bones or organs on a computer screen or on film. Your body gets rid of the radioactive substance quickly.
  • Ultrasound: An ultrasound device sends out sound waves that people cannot hear. The waves bounce off tissues inside your body like an echo. A computer uses these echoes to create a picture called a sonogram.
  • MRI: A strong magnet linked to a computer is used to make detailed pictures of areas in your body. Your doctor can view these pictures on a monitor and can print them on film.
  • PET scan: You receive an injection of a small amount of radioactive material. A machine makes pictures that show chemical activities in the body. Cancer cells sometimes show up as areas of high activity.

Biopsies
In most cases, doctors need to do a biopsy to make a diagnosis of cancer. For a biopsy, the
doctor removes a sample of tissue and sends it to a lab. A pathologist looks at the tissue under a microscope. The sample may be removed in several ways:

  • With a needle: The doctor uses a needle to withdraw tissue or fluid.
  • With an endoscope: The doctor uses a thin, lighted tube (an endoscope) to look at areas inside the body. The doctor can remove tissue or cells through the tube.
  • With surgery: Surgery may be excisional or incisional.
    • In an excisional biopsy, the surgeon removes the entire tumor. Often some of the
      normal tissue around the tumor also is removed.
    • In an incisional biopsy, the surgeon removes just part of the tumor.

    Understanding Cancer Prognosis

    Key Points

    • A prognosis is an estimate of the likely course and outcome of a disease.
    • Many factors affect the prognosis of a person with cancer, including the type, location, and stage of the cancer.
    • When estimating a patient’s prognosis, doctors usually use statistics based on data from groups of people whose situations are most similar to that of the patient.

Doctors cannot estimate with certainty what the outcome will be for an individual cancer patient.

What is a prognosis?

  • A prognosis is an estimate of the likely course and outcome of a disease. The prognosis of a patient diagnosed with cancer is often viewed as the chance that the disease will be treated successfully and that the patient will recover.What factors affect a patient’s prognosis?
    Many factors can influence the prognosis of a person with cancer. Among the most important are the type and location of the cancer, the stage of the disease (the extent to which the cancer has spread in the body), and the cancer’s grade (how abnormal the cancer cells look under a microscope—an indicator of how quickly the cancer is likely to grow and spread).
    Other factors that affect prognosis include the biological and genetic properties of the cancer cells (these properties, which are sometimes called biomarkers, can be determined by specific lab and imaging tests), the patient’s age and overall general health, and the extent to which the patient’s cancer responds to treatment.

    In estimating a cancer patient’s prognosis, doctors consider the characteristics of the patient’s disease, the available treatment options, and any health problems the patient may have that could affect the course of the disease or its ability to be treated successfully.

    The doctor bases the prognosis, in large part, on information researchers have collected over many years about hundreds or even
    thousands of people with the same type of cancer. When possible, doctors use statistics based on groups of people whose situations are most similar to that of the patient.

  • How do statistics contribute to predicting a patient’s prognosis?

Several types of statistics may be used to estimate a cancer patient’s prognosis. The most commonly used statistics are listed below.

 

Cancer-specific survival: This statistic calculates the percentage of patients with a
specific type and stage of cancer who have survived—that is, not died from their
cancer during a certain period of time (1 year, 2 years, 5 years, etc.) after diagnosis. Cancer-specific survival is also called disease-specific survival. In most cases,
cancer-specific survival is based on causes of death in medical records, which may not be
accurate. To avoid this inaccuracy, another method used to estimate cancer-specific survival that does not rely on information about the cause of death is relative survival.

Relative survival: This statistic compares the survival of patients diagnosed with
cancer (for example, breast cancer) with the survival of people in the general
population who are the same age, race, and sex and who have not been
diagnosed with that cancer. It is the percentage of cancer patients who have
survived for a certain period of time after diagnosis relative to people without cancer.

Overall survival: This statistic is the percentage of patients with a specific type and stage of cancer who are still alive—that is, have not died from any cause—during a certain period of time after diagnosis.

Disease-free survival: This statistic is the percentage of patients who have no evidence of cancer during a certain period of time after treatment. Other similar terms are recurrence-free or progression-free survival.

Cancer survival statistics are frequently given in terms of 5-year survival relative to the general population (that is, as 5-year relative survival percentages or “rates”). For example, according to NCI’s Surveillance, Epidemiology, and End Results program, the 5-year relative survival rate for all women diagnosed with breast cancer during the period from 2001 through 2007 was 89 percent and the 5-year relative survival rate for all patients diagnosed with lung cancer during the same period was 16 percent.

Because survival statistics are based on large groups of people, they cannot be used to predict exactly what will happen to an individual patient. No two patients are entirely alike, and their treatment and responses to treatment can vary greatly. Also, because it takes years to see the impact of new treatments and diagnostic tests, the statistics a doctor uses to make a prognosis may not reflect the effectiveness of current treatments.Nevertheless, the doctor may speak of a favorable prognosis if the information from large groups of people suggests that the cancer is likely to respond well to treatment. A prognosis may be unfavorable if the cancer is likely to be difficult to control. It is important to keep in mind, however, that a prognosis is only an estimate. Again, doctors cannot be absolutely certain about the outcome for an
individual patient.

Is it helpful to know the prognosis?

Cancer patients and their loved ones face many unknowns. Understanding their disease and what to expect can help patients and their loved ones make decisions about treatment, supportive and
palliative care, rehabilitation, and personal matters, such as financial matters. Seeking information about prognosis is a personal decision.

Many people with cancer want to know their prognosis. They find it easier to cope when they know the likely course of their disease. Some patients may ask their doctor about survival statistics or search for this information on their own. Other people find statistical information confusing and frightening, and they think it is too impersonal to be of value to them. It is up to each patient to decide how much
information he or she wants.

A doctor who is most familiar with a patient’s situation is in the best position to discuss his or her prognosis and explain what the statistics may mean.

What is the prognosis if a patient decides not to have treatment?

Because everyone’s situation is different, this question can be difficult to answer. Also, information used in making a prognosis often comes from studies that have compared new treatments with existing treatments rather than with “no treatment.” Therefore, it is not always easy for doctors to accurately estimate the prognosis of a patient who
decides not to have treatment. However, as mentioned above, a doctor who is most familiar with a patient’s situation is in the best position to discuss his or her prognosis.

There are many reasons why patients may decide not to have treatment. Some patients may be concerned that the benefits of cancer treatments will be outweighed by the side effects. Patients should discuss this concern with their doctor or other health care provider. Many medications are available to prevent or control the side effects caused by cancer treatments.

Some patients may decide at some point not to have treatment if they know that their type and stage of cancer has a poor prognosis, despite treatment. Patients who choose not to have active cancer treatment should talk with their doctor to ensure that they get
palliative treatment to help with the symptoms caused by their disease.

In these cases, patients may want to think about clinical trials. Clinical trials are research studies that involve people. They test new ways to prevent, detect, diagnose, or treat diseases. People who take part in cancer clinical trials have an opportunity to contribute to scientists’ knowledge about cancer and to help in the development of improved cancer therapies. They also receive state-of-the-art care from cancer experts.

What is the difference between a cure and a remission?

A cure means that treatment has successfully eradicated all traces of a person’s cancer, and the cancer will never recur (return). A cure does not mean, however, that the person will never have cancer again. It is possible that another cancer, even the same type of cancer, will develop in the person’s body at some point in the future.

A remission means that the signs and symptoms of a person’s cancer are reduced. Remissions can be partial or complete. In a
complete remission, all signs and symptoms of cancer have disappeared.

If a patient remains in complete remission for 5 years or more, some doctors may say that the patient is cured. However, some cancer cells can remain undetected in a person’s body for years or even decades after apparently successful treatment, and these cells may eventually cause a recurrence. Although most types of cancer usually recur within the first 5 years after diagnosis and treatment, later recurrences always remain a possibility. Therefore, doctors cannot say with any certainty that an individual cancer patient is cured. The most they can say is that there are no signs of cancer at this time.

Because of the possibility of recurrence, doctors continue to monitor patients for many years and do tests to look for signs of cancer’s return. They will also look for signs of delayed adverse effects from the cancer treatments received.

Staging

To plan the best treatment for cancer, the doctor needs to know the extent (stage) of your disease. For most cancers (such as breast, lung, prostate, or colon cancer), the stage is based on the size of the tumor and whether the cancer has spread to lymph nodes or other parts of the body. The doctor may order x-rays, lab tests, and other tests or procedures to learn the extent of the disease.

Treatment

Many people with cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all you can about your disease and treatment choices. However, shock and stress after the diagnosis can make it hard to think of everything you want to ask the doctor. It often helps to make a list of questions before an appointment.

Some people also want to have a family member or friend with them when they talk to the doctor – to take part in the discussion, to take notes, or just to listen.

You do not need to ask all your questions at once. You will have other chances to ask the doctor or nurse to explain things that are not clear and to ask for more information.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat cancer include surgeons, medical oncologists, hematologists, and radiation oncologists.

Getting a second opinion

Before starting treatment, you may want a second opinion about your diagnosis and treatment plan. Many insurance companies will cover a second opinion if your doctor requests it. It may take some time and effort to gather medical records and arrange to see another doctor. Usually it is not a problem to take several weeks to get a second opinion. In most cases, the delay in starting treatment will not make treatment less effective. But some people with cancer need treatment right away. To make sure, you should discuss this delay with your doctor.

There are a number of ways to find a doctor for a second opinion:

  • Your doctor may refer you to one or more specialists.
  • At cancer centers, several specialists often work together as a team.

Treatment Methods

The treatment plan depends mainly on the type of cancer and the stage of the disease.
Doctors also consider the patient’s age and general health. Often, the goal of treatment is to cure the cancer. In other cases, the goal is to control the disease or to reduce symptoms for as long as possible. The treatment plan may change over time.

Most treatment plans include surgery, radiation therapy, or chemotherapy. Some involve hormone therapy or biological therapy. In addition, stem cell transplantation may be used so that a patient can receive very high doses of chemotherapy or radiation therapy.

Some cancers respond best to a single type of treatment. Others may respond best to a combination of treatments.

Treatments may work in a specific area (local therapy) or throughout the body (systemic therapy):

  • Local therapy removes or destroys cancer in just one part of the body. Surgery to remove a tumor is local therapy. Radiation to shrink or destroy a tumor also is usually local therapy.
  • Systemic therapy sends drugs or substances through the bloodstream to destroy cancer cells all over the body. It kills or slows the growth of cancer cells that may have spread beyond the original tumor. Chemotherapy, hormone therapy, and biological therapy are usually systemic therapy.

Your doctor can describe your treatment choices and the expected results. You and your doctor can work together to decide on a treatment plan that is best for you.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each person, and they may change from one treatment session to the next.

Before treatment starts, the health care team will explain possible side effects and suggest ways to help you manage them. This team may include nurses, a dietitian, a physical therapist*, and others.

At any stage of cancer, supportive care is available to relieve the side effects of therapy, to control pain and other symptoms, and to ease emotional and practical problems.

You may want to talk to the doctor about taking part in a clinical trial (a research study of new treatment methods).

*In Ireland, physical therapists have no training in medical oncology, whereas Physiotherapists do.

For a much more detailed look at cancer, please see Cancer as a metabolic disease

For information about tests to detect cancer early, please see All Tests

 

Metastatic Cancer

  

Source: The website of the National Cancer Institute (http://www.cancer.gov)

Key Points
• Metastatic cancer is cancer that has spread from the place where it first started to another place in the body.
• Metastatic cancer has the same name and same type of cancer cells as the original cancer.
• The most common sites of cancer metastasis are the lungs, bones, and liver.
• Treatment for metastatic cancer usually depends on the type of cancer and the size, location, and number of metastatic tumors.

1. What is metastatic cancer?

Metastatic cancer is cancer that has spread from the place where it first started to another place in the body. A tumor formed by metastatic cancer cells is called a metastatic tumor or a metastasis. The process by which cancer cells spread to other parts of the body is also called metastasis.
Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to the lungs and forms a metastatic tumor is metastatic breast cancer, not lung cancer.
Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the expression of certain proteins or the presence of specific chromosome changes.
Although some types of metastatic cancer can be cured with current treatments, most cannot. Nevertheless, treatments are available for all patients with metastatic cancer. In general, the primary goal of these treatments is to control the growth of the cancer or to relieve symptoms caused by it. In some cases, metastatic cancer treatments may help prolong life. However, most people who die of cancer die of metastatic disease.

2. Can any type of cancer form a metastatic tumor?
Virtually all cancers, including cancers of the blood and the lymphatic system (leukaemia, multiple myeloma, and lymphoma), can form metastatic tumors. Although rare, the metastasis of blood and lymphatic system cancers to the lungs, heart, central nervous system, and other tissues has been
reported.

3. Where does cancer spread?
The most common sites of cancer metastasis are the lungs, bones, and liver. Although most cancers have the ability to spread to many different parts of the body, they usually spread to one site more often than others. The following table shows, in descending order from left to right, the three most common sites of metastasis, excluding lymph nodes, for several types of cancer:

Cancer typeMain sites of metastasis
BreastLungs, liver, bones
ColonLiver, peritoneum, lungs
KidneyLungs, liver, bones
LungsAdrenal gland, liver, lungs
MelanomaLungs, skin/muscle, liver
OvariesPeritoneum, liver, lungs
PancreasLiver, lungs, peritoneum
RectumLiver, lungs, adrenal gland
Stomach Liver, peritoneum, lungs
Thyroid Lungs, liver, bones
UterusLiver, lungs, peritoneum

4. How does cancer spread?
Cancer cell metastasis usually involves the following steps:
Local invasion: Cancer cells invade nearby normal tissue.
Intravasation: Cancer cells invade and move through the walls of nearby lymph vessels or blood vessels.
Circulation: Cancer cells move through the lymphatic system and the bloodstream to other parts of the body.

Metastatic cancer cells invade lymph vessels and blood vessels near a tumor and migrate to other parts of the body.
Arrest and extravasation: Cancer cells arrest, or stop moving, in small blood vessels called capillaries at a distant location. They then
invade the walls of the capillaries and migrate into the surrounding tissue.
Proliferation: Cancer cells multiply at the distant location to form small tumors known as micrometastases.
Angiogenesis: Micrometastases stimulate the growth of new blood vessels to obtain a blood supply. A blood supply is needed to obtain the oxygen and nutrients necessary for continued tumor growth.
Because cancers of the lymphatic system or the blood system are already present inside lymph vessels, lymph nodes, or blood vessels, not all of these steps are needed for their metastasis. Also, the lymphatic system drains into the blood system at two locations in the neck.
The ability of a cancer cell to metastasize successfully depends on its individual properties; the properties of the noncancerous cells, including immune system cells, present at the original location; and the properties of the cells it encounters in the lymphatic system or the bloodstream and at the final destination in another part of the body.

Not all cancer cells, by themselves, have the ability to metastasize. In addition, the noncancerous cells at the original location may be able to block cancer cell metastasis. Furthermore, successfully reaching another location in the body does not guarantee that a metastatic tumor will form. Metastatic cancer cells can lie dormant (not grow) at a distant site for many years before they begin to grow again, if at all.

5. Does metastatic cancer have symptoms?

Some people with metastatic tumors do not have symptoms. Their metastases are found by x-rays or other tests.
When symptoms of metastatic cancer occur, the type and frequency of the symptoms will
depend on the size and location of the metastasis. For example, cancer that spreads to the bones is likely to cause pain and can lead to bone fractures. Cancer that spreads to the brain can cause a variety of symptoms, including headaches, seizures, and unsteadiness. Shortness of breath may be a sign of lung metastasis. Abdominal swelling or jaundice (yellowing of the skin) can indicate that cancer has spread to the liver.
Sometimes a person’s original cancer is discovered only after a metastatic tumor causes symptoms. For example, a man whose prostate cancer has spread to the bones in his pelvis may have lower back pain (caused by the cancer in his bones) before he experiences any symptoms from the original tumor in his prostate.

6. Can someone have a metastatic tumor without having a primary cancer?

No. A metastatic tumor is always caused by cancer cells from another part of the body.
In most cases, when a metastatic tumor is found first, the primary cancer can also be found. The search for the primary cancer may involve lab tests, x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, positron emission tomography (PET) scans, and other procedures.
However, in some patients, a metastatic tumor is diagnosed but the primary tumor cannot be found, despite extensive tests, because it
either is too small or has completely regressed. The pathologist knows that the diagnosed tumor is a metastasis because the cells do not look like those of the organ or tissue in which the tumor was found. Doctors refer to the primary cancer as unknown or occult (hidden), and the patient is said to have cancer of unknown primary origin (CUP).

7. If a person who was previously treated for cancer gets diagnosed with cancer a second time, is the new cancer a new primary cancer or metastatic cancer?
The cancer may be a new primary cancer, but, in most cases, it is metastatic cancer.

8. What treatments are used for metastatic cancer?
Metastatic cancer may be treated with systemic therapy (chemotherapy, biological therapy, targeted therapy, hormonal therapy), local therapy (surgery, radiation therapy), or a combination of these treatments. The choice of treatment generally depends on the type of primary cancer; the size, location, and number of metastatic tumors; the patient’s age and general health; and the types of treatment the patient has had in the past. In patients with CUP, it is possible to treat the disease even though the primary cancer has not been found.

9. Are new treatments for metastatic cancer being developed?
Yes, researchers are studying new ways to kill or stop the growth of primary cancer cells and metastatic cancer cells, including new ways to boost the strength of immune responses against tumors. In addition, researchers are trying to find ways to disrupt individual steps in the metastatic process.

Before any new treatment can be made widely available to patients, it must be studied in clinical trials (research studies) and found to be safe and effective in treating disease. NCI and many other organizations sponsor clinical trials that take place at hospitals, universities,
medical schools, and cancer centers around the country. Clinical trials are a critical step in improving cancer care. The results of previous clinical trials have led to progress not only in the treatment of cancer but also in the detection, diagnosis, and prevention of the disease. Patients
interested in taking part in a clinical trial should talk with their doctor.

Selected References
1. Patel JK, Didolkar MS, Pickren JW, Moore RH. Metastatic pattern of malignant melanoma: a study of 216 autopsy cases. American Journal of Surgery 1978; 135(6):807–810. [PubMed Abstract]
2. Disibio G, French SW. Metastatic patterns of cancer: results from a large autopsy study. Archives of Pathology & Laboratory Medicine 2008; 132(6):931–939. [PubMed Abstract]
3. Talmadge JE, Fidler IJ. AACR centennial series: the biology of cancer metastasis: historical perspective. Cancer Research 2010; 70(14):5649–5669. [PubMed Abstract]
4. Coghlin C, Murray GI. Current and emerging concepts in tumour metastasis. Journal of Pathology 2010; 222(1):1–15. [PubMed Abstract]
5. Viadana E, Bross ID, Pickren JW. An autopsy study of the metastatic patterns of human leukaemias. Oncology 1978; 35(2):87–96. [PubMed Abstract]
6. Otto CM. Cardiac masses and potential cardiac “source of embolus.” In: Textbook of Clinical Echocardiography. 4th ed. Philadelphia: Elsevier, Inc., 2009.
7. Schluterman KO, Fassas AB, Van Hemert RL, Harik SI. Multiple myeloma invasion of the central nervous system. Archives of Neurology 2004; 61(9):1423–1429. [PubMed Abstract]
8. Grier J, Batchelor T. Metastatic neurologic complications of non-Hodgkin’s lymphoma. Current Oncology Reports 2005; 7(1):55–60. [PubMed Abstract]
9. Aragon-Ching JB, Zujewski J. CNS metastasis: an old problem in a new guise. Clinical Cancer Research 2007; 13(6):1644–1647. [PubMed Abstract]

Note: Images and videos do not form part of the original articles.

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