Metastatic Cancer

Metastatic cancer refers to cancer that has spread beyond the point of origin to other, distant areas of the body. Metastasis is a word used to describe the spread of cancer. Unlike normal cells, cancer cells have the ability to grow outside of the place in your body where they originated.

What types of cancer are most likely to metastasize? #

As mentioned above, virtually all types of cancers can spread beyond the point of origin. Some of the most common types include metastatic:

• Breast cancer.

• Prostate cancer.

• Lung cancer.

• Kidney cancer.

• Thyroid cancer.

• Colon cancer.

• Pancreatic cancer.

• Bone cancer.

• Liver cancer.

Causes of Metastatic Cancer #

Metastatic cancer occurs when cancer cells break off from the original tumor and spread to other parts of the body via bloodstream or lymph vessels.

Symptoms of Metastatic Cancer #

Bone metastasis #

Bone metastasis may or may not cause pain. The first sign of bone metastasis is bone breakage after a minor injury or no injury. Severe back pain accompanied by leg numbness or difficulty with bowel or bladder control must be evaluated immediately.

Brain metastasis #

If a tumor has metastasized to the brain, symptoms may include headache, dizziness, visual problems, speech problems, nausea, difficulty walking or confusion.

Lung metastasis #

Cancer symptoms of lung metastasis are usually very vague. This is because they can be similar to symptoms of other health conditions. Warning signs may include a cough (productive or nonproductive), coughing up blood, chest pain or shortness of breath.

Liver metastasis #

Liver metastasis can cause pain, weight loss, nausea, loss of appetite, abdominal fluid (ascites) or jaundice (yellowing of the skin and the whites of eyes).

Diagnosis of Metastatic Cancer #

Blood tests #

Routine blood tests can tell your provider if your liver enzymes are elevated. This could indicate liver metastasis. In many cases, however, these blood test results are normal, even in the presence of advanced cancer.

Tumor markers #

Some cancers have tumor markers that can be helpful in monitoring cancer after diagnosis. If tumor marker levels increase, it could mean that your cancer is advancing. Some examples are:

• Colon cancer: CEA (carcinoembryonic antigen).

• Ovarian cancer: CA-125.

• Prostate cancer: PSA (prostate-specific antigen).

• Testes cancer: AFP (alpha-feto-protein) and HCG (human chorionic gonadotropin).

• There are several tumor markers that are less specific, and therefore, not used as a tool for diagnosing metastasis.

Imaging #

There are many tests that take pictures of the inside of your body. Appropriate tests depend on the symptoms and the type of cancer. Imaging tests may include:

• Ultrasoundis one way to evaluate the abdomen and identify any tumors. It can detect fluid in the abdomen and can show the difference between fluid-filled cysts and solid masses.

• CT scan (computed tomography) can detect abnormalities in the head, neck, chest, abdomen and pelvis. It can also identify tumors in the lungs, liver or lymph nodes.

• A bone scan is done with a radioactive tracer that attaches to damaged bones and shows as a hot spot on the scan. It’s most useful for evaluating the whole body for evidence of cancer-related bone damage. If your provider suspects a fracture, they may take additional X-rays to determine the extent of the damage.

• MRI (magnetic resonance imaging) uses radio waves and magnets to take pictures inside of your body. MRI can detect spinal cord damage or identify brain metastasis.

• PET scan (positron emission tomography) works to identify abnormalities anywhere in the body. It uses a special dye containing radioactive tracers that light up problematic areas.

Treatment of Metastatic Cancer #

Bone metastasis #

If bone tumors aren’t causing pain, your provider may monitor your situation or recommend drug therapy. If there is pain or if the bone tissue is weak, your provider may recommend radiation therapy.

Brain metastasis #

Depending on the extent of disease and the number of metastatic tumors, treatment options may include surgery, chemotherapy, radiation therapy, gamma knife surgery or steroids.

Lung metastasis #

• The treatment of metastatic tumors in the lung depends on the specific situation.

• In most cases, it will be treated with the same drugs as the primary cancer (where cancer originated).

• If fluid builds up around the lungs, a procedure called thoracentesis can make breathing easier.

Liver metastasis #

• There are a number of ways to treat metastatic tumors of the liver.

• The appropriate treatment depends on the type of primary cancer and the number of metastatic tumors.

• In many cases, your provider will treat liver metastases the same way they treated the primary tumor.

• If the disease hasn’t spread too far, then your provider may recommend surgery or radiofrequency ablation (RFA). Organ transplant is generally not an option for metastatic disease.